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HomeMy WebLinkAboutABC NM CHAPTER AUI INC - INSURANCE CERTIFICATE/DD/YY) �z/o6 Services, Inc. of New Mexico V THISCERTIFICATEIS ISSUED ASAMATTEROFINFORMATIONONLY n Blvd NE AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Albuquerque NM 87110 USA COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE SOS 889-6700 FAX• 505 884-7831 INSURERS AFFORDING COVERAGE INSURED INSURER A: Midwest Employers Cars. CO. ABC NM Chapter Merit Shop -WC Group AUI Inc. INSURER B: P.O. BOX 9825 Albuquerque NM 87119-9825 USA INSURER c: a INSURER D: W1 U wit wrier C INSURER E: d r. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED O ,NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY � x PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIV POLICY EXPIRATION LIMITS a) DATE(MM\DD\YY) DATE(MM\DD\YY) GENERAL LIABILITY EACH OCCURRENCE ^� O� COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one tire) CLAIMS MADE ❑ IX;CUR MED EXP (Anv one mmn) p n PERSONAL & ADV INJURY GENERAL AGGREGATE GENT AGGREGATE LIMIT APPLIES PER: PRO- POLICY LOC PRODUCTS - COMP/OP AGO JECT z v AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 6U ANY AUTO (Ea accident) t Y ALL OWNED AUTOS BODILY INJURY () SCHEDULED AUTOS ( Per person) HIRED AUTOS BODILY INJURY NON OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESS LIABILITY EACH OCCURRENCE OCCUR ❑ CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION A WORKERS COMPENSATION AND EWC007548 03/01/06 03/01/07 X WC STATU- OTH- EMPLOYERS' LIABILITY SIR Deductible $350,000 T RY LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 _ E.L. DISEASE -EA EMPLOYEE $1,000,000 OTHER `Ti r_ mrJ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Pipe Bursting Project City Of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEXRATION Purchasing Division DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 215 N. Mason Street 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Fort Collins CO 80522 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATTON OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _.r - _ .�g-. :•s..;:as: .®.. ._.�, .. a. � DATE(MMJDDJYY ACORDrM 02/22/06 PRODUCER ADD Risk Services, Inc. of New Mexico THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 6000 Uptown Blvd NE AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS suite 400 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE Albuquerque NM 87110 USA COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE SOS 889-6700 FAx- 505 884-7831 INSURERS AFFORDING COVERAGE INSURED INSURER A: Midwest Employers Cas. Co. ABC NM Chapter Merit Shop -WC Group INSURERB: AUI Inc. P.O. BOX 9825 INSURER C:' f6 Albuquerque NM 87119-9825 USA INSURER D: 0 b i4@ INSURER E. THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVEPOLICY DATE(MMIDDWY) EXPIRATION DATE(MMIDD\YY) LIMITS GENERAL LIABILMY EACH OCCURRENCE FIRE DAMAGE(ARY one fire) COMMERCIAL GENERALLIABILITY CLAIMS MADE ❑ OCCUR MED EXP (Any one Pcrson) PERSONAL & ADV INJURY GENERAL AGGREGATE GENT, AGGREGATE LIMIT APPLIES PER: PRO - PRODUCTS -COMP/OP AGO POLICY 0 JECT M LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS ( Per person) BODILY INJURY HIRED AUTOS NON OWNED AUTOS (Per occident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY AGG EXCESS LIABILITY EACH OCCURRENCE OCCUR ❑ CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION A EMPLOYWORKERSCOMABILITIONAND EMPLOYERS' LIABILITY EW0007548 SIR Deductible $350,000 03/01/06 03/01/07 X WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $1, OOO, 000 E.L. DISEASE -POLICY LIMIT $1, 000, 000 E.L. DISEASE -EA EMPLOYEE $1,000,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTJSPECIAL PROVISIONS RE: Pipe Bursting Project City of Fort Collins Purchasing Division 215 N. Mason street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Fort Collins CO 80522 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE c- Aae".", O x ACQJ46. DATE(MM/DD/YY) 02/22/06 lneonDD Risk Services, Inc.Of New Mexico A On THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 6000 Uptown Blvd NE AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS Suite 400 Albuquerque NM 87110 USA CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PHONE -(SOS) 889-6700 FAX- SOS 884-7831 INSURERS AFFORDING COVERAGE INSURED INSURER A: Midwest Employers Cas. CO. ABC NM Chapter Merit Shop -WC Group AUI Inc. INSURER B: P.O. BOX 9825 Albuquerque NM 87119-9825 USA INSURER C: INSURER D: INSURER E�. C d 'O H THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIV DATE(MM\DINYY) POLICY EXPIRATION DATE(MM\DD\YY) LIMITS O r` GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE ❑ OCCUR EACH OCCURRENCE m 01 n O n FIRE DAMAGE(Aoy one fie) MED EXP (Any one Person) PERSONAL & ADV INJURY GENERAL AGGREGATE GFNL AGGREGATE LIMIT APPLIES PER: PRO- POLICY 1:1JECT LOC .. O z PRODUCTS -COMP/OP AGG v V R AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT u W' ANY AUTO ALL OWNED AUTOS (Ea accident) t Y V BODILY INJURY SCHEDULED AUTOS (Pm person) BODILY INJURY HIRED AUTOS NON OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accidem) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY AGG EXCESS LIABILITY EACH OCCURRENCE OCCUR F-1 CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION A WORKERS COMPENSATION AND EMPLOYERS'LIABI.ITY EW0007548 SIR Deductible $350,000 03/01/06 03/01/07 X WC STATU- ORY LIMITS OTH- ER E.L. EACH ACCIDENT $1,000,000 0 E.L. DISEASE -POLICY LIMIT $1,000,000 _ E.L. DISEASE -EA EMPLOYEE $1,000,000 OTHER Y DESCRIPTION OF OPERATIONSJLOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Pipe Bursting Project City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Purchasing Division DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 215 N . Mason street BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY Fort Collins Co SOS22 USA OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. L �� Vd AUTHORIZED REPRESENTATIVE CL �4��y6 L