HomeMy WebLinkAbout109888 INSITUFORM TECHNOLOGIES INC - INSURANCE CERTIFICATE (12)ACORD. CERTIFICATE OF LIABILITY INSURANCE m/oli2oo7
08/ 3 zoo
rRoolNCER
LoddonCompanies
Three City Place Drive, Su4e 900
St. Louis MO 63141-7081
(314) 432-05M
THIS CERTIFICATEIISSUED MATTER OF
ONLY ANDCON ERS NORIGHTSUPONINFORMATION
THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFF RDED BY THE LI IES BELOW.
INSURERS AFFORDING COVERAGE
INSURED
1041932 ftdutorm Te&mbgiK Inc.
702 Spirit 40 Pall( Drive
Chesteff*W MO 63005
INSURER A: Liberty Mutual Fire Insurance 64
INSURER B : Liberty Insurance CO 64
INSURER C :
INSURER D :
INSURER E:
I IRS l.-ClilIrAiAIC VI•IN5111NiI1R.-C IJVC�ITV1 WMIIIUICAWRllf lUL LIUM II$
LVVCNIA%iC3 GV jtMBLMjALMWB= REPRESENTATNE OR PRODUCER AND THE CERTIFICATE HOLDER.'
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
POLICES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
SUN! JIMIL
TYPE of IItSI111AlICE
POLICY NUMBER
POLICY EFFECTIVE
DATE 0111111VOrM
POLICY EXPIRATION
DATE RAMIDDIM
uM119
GENERAL LIABILITY
EACH OCCURRENCE
t 2,000,000
FIRE DAMAGE we rw
$ 100,000
A
X OOMMMERc1AL GENERAL LIABILITY
CLAW MADE FxI OCCUR
TB2-641-W4218-036
07/01/2006
07ro112007
MED EXP Gee
t 10,000
PERSONAL a ADV INJURY
t 2,000,000
X INDPNT CONTRACTOR
BROAD FORM PD/C0NTRACrL
AL
X
XCU
GENERAL AGGREGATE
t 42000,000
GENL AGGREGATE LIMIT APPLES
POLICY X JEcT Floc
PER:
PRODUCTS -COMWOP AGO
t 4000000
A
ALRO
X
NOBLE LIABILITY
ANY AUTO
AS2-641-004218-026
07/01/2006
(7/01/2007
COMBINED SINGLE UNIT
(Ea I
T 2'�'�
BODILY INJURY
(Per rl
t )CX)CXJXX
ALLOWN® AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Pe, ml
t XXXXXXNON-OWNED,
HIRED AUTOS
NON -OWNED, AUTOS
X
sical Damage
PROPERTY DAMAGE
(Pere darlt)
t XX)CXX)CX
X
Deduct- tic
GARAGE LIABILITY
AUTO ONLY -FA ACCIDENT
t xxxx xx
OTHER THAN EA ACCt
AUTO ONLY: AGG
)p(=NXX
ANY AUTO
NOT APPLICABLE
t XXXXXXX
LIABILITY
occ urt ❑ CLAIMS MADE
NOT APPLICABLE
EACH OCCURRENCE
t xxxxxxx
AGGREGATE
t }p{7p1xxx
t XXXXXJ x
A
DEDUCIBLE ❑ FOBI
X)cx [)0cx
t XX)C{XXX
RETENTION t
B
WoeNERSCowENSATIONAM
WA7-64D-009OD4446
07/01/2006
GUOY2007
x WMk OR
E.L. EACH ACCIDENT
It I g00,000
B
EMPLOYERS' LIABILITY
WC7b41-004218-016 (WI&OR)
07/0t/2006
WIO YL007
EL DISEASE - EA EMPLOYEE
It 1000 000
EL DISEASE- POUCY LIMT
It 1000 00D
OrNER
OEWRWrNMOF OPERATWNBLOCATWMUVEMCLPBIEXCLOSlOM ADD®BY BOORSUM99 SPECW. PROVOKM
R& 2006 INSITUFORM PROJECT, 6" LINING PROJECT IN THE 8DO BLOCK OF GARFIELD STREET. THE CITY OF FORT COLLINS IS ADDITIONAL
INSURED UNDER GENERALLtABILITYAND AUTOMOBBELIABJUTYAS REQUIRED BY WRITTEN CONTRACT.
CERTIFICATE HOLDER
ADDITIONALINsunim IBtIRMLETTER: _ CANCELLATION
CITY OF FORT COLLINS
P.O. BOX 580
SHOULD ANY OF THE ABOVE OESCRIBED POLICES BE CANCELLED ED BEFOTETHE EXPIRATION
DATE THEREOF, THE ISSUING INSURER IN.L ENDEAVOR TO MAR 30 DAYS WRITTEN
FORT COLLINS CO 80522
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 90 SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY IOND UPON THE INSURER, ITS AGENTS OR
REPRESENTATME9.
AUMORIZED RBRESENTATNE
e trmr) luueo,,..eeGN,ey a,.as�I meenreTmt•. O ACORD CORPORATION 1908