HomeMy WebLinkAboutSMITH GEOTECHNICAL ENGINEERING - INSURANCE CERTIFICATEAC-080 CERTIFICATE OF LIABILITY INSURANCE OP ID
SMITA6
DATE(MMIDONyrn
02 08 06
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown A Brown Inc - Ft Collins
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, 5th Floor
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P 0 Box 2226
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80522-2226
Phone: 970-482-7747 Fax: 970-484-4165
INSURERS AFFORDING COVERAGE NAIC #
INSURED
INSURER A: FicialitY c Guaranty insurance
INSURERB: Pinnacol Assurance
Smith Gaotechnical Engineering
Inc.
INSURERC:
INSURERD: j
1225 Red Cedar Circle, Ste H
Ft. Collins CO 90524
INSURER E: j
COVERAGES
THE POUCIES 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.
LTR
INSR
TYPE OF INSURANCE
POLICY NUMBER
DATE MMIDDNY)
DATE MMID
LIMITS
A
X
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7OCCUR
X Business Owners
BM02168683
02/10/06
02/10/07
EACH OCCURRENCE
$1000000
PRE7iSES(4 oeara,ce)
$300000
MED EXP(Any we person)
$10000
PERSONAL BADVINJURY
$1000000
GENERAL AGGREGATE
22000000
GEWL AGGREGATE LIMIT APPLIES PER:
17 POLICY LOC
PRODUCTS-COMPIOPAGG
s2000000
A
A
A
X
AUTOMOBILE
LIABILITY
my AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
BA02168681
BA02168681
BA02168681
02/10/06
02/10/06
02/10/06
02/10/07
02/10/07
02/10/07
COMBINED SINGLE LIMIT
(Es aeadentl
$1 000 000
X
BODILY INJURY
(Per pin)
S
X
BODILY INJURY
("f8tadent)
$
X
PROPERTY DAMAGE
(Psi eccidern)
S
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
S
OTHER THAN EA ACC
AUTO ONLY: AGG
$
S
EXCESSNMBRELLA LIABILITY
OCCUR 71 CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
S
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS'UABIUTY
ANY PROPRIETORIPARTNER(EXECUTNE
OFFICERIMEMBER EXCLUDED?
M yyeess describe under
SPECIAL PROVISIONS below
4066328
02/01/06
02/01/07
TORY LIMITS I i ER
E.LEACHACCIDENT
$100000
E.L. DISEASE -EA EMPLOYE
SlO0000
E.L. DISEASE -POLICY LIMIT
$500000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CITYGR2 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR UABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATNES.
ACORD 25 (2001108)
ARCHITECTS/ENGINEERS PROGRAM
CHA
AGENCY BRANCH
POLICY
DECLARATIONS
PREFIX POLICY NUMBER
056124 969 AEA 11-412-00-94
INSURANCE IS PROVIDED BY
CONTINENTAL CASUALTY COMPANY,
CNA PLAZA, CHICAGO, IL 60685,
A STOCK INSURANCE COMPANY,
HEREIN CALLED WE, US, OR OUR.
NOTICE
THIS IS A CLAIMS -MADE POLICY. PLEASE READ THIS POLICY CAREFULLY AND
DISCUSS THE COVERAGE WITH YOUR INSURANCE AGENT OR BROKER.
1. NAMED INSURED:
SMITH GEOTECHNICAL
2. ADDRESS:
1225 Red Cedar Circle
Suite H
Fort Collins, Colorado 80524
�. POLICY TERM: From: 05/01/2005 To: 05/01/2006 AT 12:01 a.m.
Standard time at your address shown above.
4. KNOWLEDGE DATE: 05/01/01
5. DEDUCTIBLE:
a. $ 5,000 Purchased Deductible
b. $ 1,250 Deductible Credit
C. $ 3,750 is Deductible per claim (including claim expenses)
d. $ N/A is Aggregate Deductible per policy year
(including claim expenses)
6. LIMIT OF LIABILITY:
a. $ 1,000,000 Per claim limit of liability (including claim expenses)
b. $ 1,000,000 Aggregate limit of liability per policy year
(including claim expenses)
7. INCEPTION DATE: 05/01/01 is the date of the first policy issued to
you and continuously renewed by us.
159772
G-136512-A17 -1 -
(ED. 07/'03 )