HomeMy WebLinkAbout109244 WASTE MANAGEMENT UNITED SITE SERVICES - INSURANCE CERTIFICATE (2)DATE (MWDDNY)
ACORD,. CERTIFICATE OF LIABILITY INSURANCE 11/03/2006 1 10/26/2005
PRODUCER Lockton Companies THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
P ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
444 W. 47th Street, Suite 900 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Kansas City Mo 64112-1906 T AFFORDEDY H CIE
(816) 960-9000 INSURERS AFFORDING COVERAGE
INSURED
1051643 UNITED SITE SERVICES
P.O. BOX 219
COMMERCE CITY CO 80037
COVERAGES TJWTST02 XO
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
TR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDI
POLICY EXPIRATION
DATE (MMIDDfM
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [ X1 OCCUR
X CONPRACTUAL/XCU
RG2641435338025
11/03/2005
11/03/2006
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire
S 100,000
MED EXP onePerson)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000.000
X
POLLUTION
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES
POLICY F1 JET
PER:
LOC
PRODUCTS - COMP/OP AGG
$ 2 000 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON-0WNED AUTOS
AS2641435338035
11/03/2005
11/03/2006
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
X
BODILY INJURY
(Per person)
$ XXXXXXX
X
BODILY INJURY
(Per accident)
$ XXXXXXX
X
PROPERTYDAMAGE
(Per accident)
$ XXXXXXX
GARAGE LIABILITY
ANY AUTO
NOT APPLICABLE
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHERTHAN EA ACC
AUTO ONLY: AGG
$ XXXXXXX
$ XXXXXXX
B
EXCESS LIABILITY
7x:l OCCUR CLAIMS MADE
0 UMBRELLA
DEDUCTIBLE FORM
RETENTION $
AUC427541601
11/03/2005
11/03/2006
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
XXXXXXX
XXXXXXX
$ XXXXXXX
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WA764D435338015
11/03/2005
11/03/2006
X WC STATU- DTH-
FR
E.L. EACH ACCIDENT
S 1 000 000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
8 1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CITY OF FORT COLLINS IS AN ADDITIONAL INSURED AS REQUIRED BY WRITTEN CONTRACT.
2317523 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30
PO BOX 580 DAYS WRITTEN
FORT COLLINS CO 80522 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25-S (7/97) Fo gmvtions mgmMina this certificate, contacettm number lima In tM•Pronucer saclim almveanC specNy thecltent Cale 11NIS102'. CDACORD C PORATION IQRR