HomeMy WebLinkAbout125216 WALSH ENVIRONMENTAL SCIENTISTS - INSURANCE CERTIFICATE (3)DNYY
ACORD CERTIFICATE OF LIABILITY INSURANCE �Toa/lerz008 Y) TM
PRODUCER Phone (303)6/31M F. (303)a3-7E01
MEYERSDINING PROPERTY CASUALTY LLC
THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
3223 ARAPAHOE AVE STE 300
HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR
BOULDER CO 80303
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE
NAIC #
Ud1 86073
INSURED
INSURER A Pinnecol Assurance
800021
Walsh Environmental Scientists & Engineers LLC
INSURER B
4888 Pearl East Circle
Suite /08
INSURER C 1
INSURER D
- �d
Boulder CO 80301
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE SEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIM 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 ANY HAVE BEEN REDUCED BY PAID CLAIMS
—
LTR
TYPE OF MISURANCE
POLICY NUMBER
POLICY ensme
DATE
POLICY EXPitAr1oN
DATE
LmTs
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE[ OCCUR
EACH OCCURRENCE
$
Tu
PPEARIEB 4m�nv
S
MED EXP (Any OIM Panto)
$
PERSONAL 6 ADV INJURY
S
GENERALAGGREGATE
$
GEM AGGREGATE LIMIT APPLIES PER
PROCT LOC
POLICY 7
PRODUCrSCOMP/OP AGO
$
AUTOMOBILE
UABILTA
ANY AUTO
ALL OWNED ALTOS
SCHEDUEDAUTOS
HIRED ALTOS
NONOWNED AUTOS
COMBINED SINGLE LIMIT
(6 student)
S
BODILY INJURY
(PN person)
$
BODILY INJURY
(Pa acddMM)
S
PROPERTY DAMAGE
(Pb emJdenl
$
GARAGE LIABILITY
71 ANY ALTO
ALTOONLV FA ACCIDENT
$
OTHER TO UNLAN EA ACC
AUONLY AGG
$
$
EXCESS I UMBRELLA LABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
S
A
WORKERS COMPENSATION AM
EMPLOYERS' LU1NUl
ARreaoeslETORRAImesnucullYr
aF:iT1MNBHBaI IXCLIIOEOT
M yeti tluuM urM�r
sPECAL PRWaIOW eYaw
4045661
08/01/07
08/01/08
X TMORVTIATR OTXBI
E L EACH ACCIDENT
$ 1 000 000
E L DISEASE -EA EMPLOYEE
S 1 000 000
E LDISEASE-POLICY LIMIT
$ 1 000 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Fort Collins
Purchasing Divleron
EXPIRATION DATE THEREOF THE ISSUING INSURER YALLENDEAVOR TO MAIL 10 DAYS
WRITTEN 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
P D Box 580
ITS AGENTS OR REPRESENTATIVES
Fort Collins CO 85022
AUTHORIZED REPRESENTATIVE
_, gnaRJaR1
Attention
ACORD 25 (2001108) Cer40cate # 5980 of ecnwn Cn0Dn0ATInM 4022
241
Ixd 111 d: LTA
ACORD, CERTIFICATE OF LIABILITY
INSURANCE
DATE
03/19/08D
PRODUCER
HRH of Upstate New York LLC
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
344 Delaware Avenue
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Buffalo NY 14202
716 856 1100
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Walsh Environmental Scientists &
Engineers LLC
4888 Pearl E Circle Ste 108
Boulder CO 80301
INSURERA Commerce & Industry Ins Co
19410
INSURER B
INSURERC
INSURER D
INSURER
COVERAGES
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
LMR
TR
WD'
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMM/D01M
POLICY EXPIRATION
DATE IMMIDDIM
LIMITS
A
GENERAL UJU211 JTY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 51OCCUR
GL4178739
08/01/07
08/01/08
EACH OCCURRENCE
E3 00D 000
DAMAGE TO RENTED
$500 DDD
MEDEXP(Any.INNsm)
$50000
PERSONAL S ADV INJURY
s3,000,000
GENERALAGGREGATE
s3,000,000
GEN L AGGREGATE LIMIT APPLIES PER
PRo- X LOC
POLICY X JE
PRODUCTS COMP/OPAGG
a3000000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-0WNED AUTOS
CA5053647
08/01/07
08/01108
COMBINED SINGLE LIMIT
(Eea Tit)
E2 BBB BBB
X
BODILY INJURY
(Per persm)
$
X
BODILY INJURY
(Per ac wt)
$
X
PROPERTY DAMAGE
(Peramderet)
E
GARAGE LIABILITY
ANY AUTO
AUTOONLY EAACGDENT
E
OTHER THAN EA ACC
AUTO ONLY AGO
E
$
A
EXCESS/UMBRELLALIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION E 10000
BE7251290
08/01/07
08/01/08
EACH OCCURRENCE
$16006000
X
AGGREGATE
$10006 000
S
E
X
E
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY
ANY PROPRIETOR/PARTNEWEXECUTIVE
OFFICER/MEMBER EXCLUDED?
If ye tlesc be und.
SPECIAL PROVISIONS below
OT
WC STATU H
EL EACH ACCIDENT
B
EL DISEASE EA EMPLOYEE
1
EL DISEASE POLICYLIMIT
E
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVSIONS
RE Environmental Services The City of Fort Collins is named as
(See Attached Descriptions)
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 An DAYS WRITTEN
215 North Mason Street
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
P O Box 580
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
Fort Collins CO 80522-0580
REPRESENTATIVES
ACORD 25 (2001108) 1 of 3 #M38853 SMD o ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED the policy(ies) must be endorsed A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s)
If SUBROGATION IS WAIVED subject to the terms and conditions of the policy certain policies may
require an endorsement A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s)
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s) authorized representative or producer and the certificate holder nor does it
affirmatively or negatively amend extend or alter the coverage afforded by the policies listed thereon
ACORD 25S (2001108) 2 of 3 #M38853
DESCRIPTIONS (Continued from Page 1)
an additional insured on the general liability as required by written
contract
AMS 25 3 (2001108) 3 of 3 #M38853