HomeMy WebLinkAbout109888 INSITUFORM TECHNOLOGIES INC - INSURANCE CERTIFICATE (3)ACORD,M CERTIFICATE OF LIABILITY INSURANCE 7/1/2009 DAT7/1/2008 VI
PRODUCER Lockton Companies,LLC-1 St. Louis THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Three City Place Drive, Suite 900 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
St. Louis 63141-7081 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
(314) 432-0500 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURED InsltUlorm Technologies, Inc. INSURER A- Llbety MUmal Fire Insnnnce Company Rid) 23035
1041932 17988 Edison Avenue wsuRER B= Liberty Inswznce Cot potation (64) 42404
Chesterfield MO 63005
INSURER C
INSURER E'
Crux/FRAr:FS IN'11114l? ?Q THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING.
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING I
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.
HER
LTR
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE(MMIDD/YY)
POLICY EXPIRATION
DATE IMMIDDNY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
S 2,000,000
A
X COMMERCIAL GENERAL LIABILITY
1'132-641-004218-038
7/1/2008
7/I/2009
DAMAGE 10 RENTED
PREMISES Ea ocwooco
$ 350,000
NEED EXP (Any one person)
$ 10,000
CLAIMS MADE FRI OCCUR
A
X IIldependt COMMODE
BROAD FORM PD/CON I'RAC HJ
Al,
PERSONAL B ADV INJURY
$ 2 000,000
X
XC(J
GENERAL. AGGREGAIE
$ 4 000 000
A
PER PROJI,cl AGE. CAP $20M
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUC IS - COMPIOP AGO
ff 4,000,000
PRO -
POLICY X I JECT LOC
A
AUTOMOBILE
LIABILITY
AS2-641-004218-028
7/I/2008
7/I/2009
COMBINED SINGLE LIMIT
X
ANY AU TO
Ice accident)
$ 2,000,000
BODILY INJURY
ALL OWNED AUTOS
SCI TDUI.FD AUTOS
(Per person)
$ XXXXXXX
BODILY INJURY
S XXXXXXX
HIRED AU I OS
NON-OWNEDAUTOS
(Per accident)
P}{YSICAL DAMAGE
X
PROPERTY DAMAGE
$ XXXXXXX
PER POLICY
(Per accident)
GARAGE LIABILITY
AUTOONLY EAACCIDENT
$ XXXXXXX
NOIAPPLICAHLE
OTHER TITAN EA ACC
$ XXXXXXX
ANY AUTO
AUTO ONLY AGO
$ XXXXXXX
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$ XXXXXXX
AGGREGATE
$ XXXXXXX
OCCUR CLAIMS MADE-
UMBRELLA
NOI-APPLICA131'11
$ XXXXXXX
❑
DEDUCTIBLE FORM
$ XXXXXXX
$ XXXXX'X}(
RETENTION $
13
WORKERS COMPENSATION AND
WA7-641)-009004-448
7/l/2008
7/1/2009
X VVC STATU- OTIi
iORY LIMITS ER
13
' EMPLOYERSLIABILITY
WC7-641-004218-018 (WI OR)
7/1/2009
7/1/2009
1,000,000
ANY E ['%[CUTIVE
E.L. EAOH Ai:G DF.N I
$
C[ RIM
OFFICI RIMr.MDER EXCLUDE
BER EXCLUDE
EL. IJISEASE- EA EMPLOYEE
$ 1,000,000
If yes, nemrlbc under
SPECIHt. NO
F.I_OISEASI-POLICY LIMIT
$ 1,000,000
PRovI510N5 below
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
kl::. P-1022 CURI'D IN PLACE PIPI SANITARY AND STORM SI WLRS. It 11' CITY OF FOR I' C01 1 II NS ITS OFFICERS, ICERS, AGFN'I'S AND
I MPI.OYI I S ARF ADDITIONAL INSUREDS UND1:.12 GGNJRAL LIAHIIJIY AND AUI'OM01311.1{ LIABILI''IY AS RI QUIR D 13Y WRIT I'I:N
CON'I'RAC I:XCI 1 ION TO CANC I. LLAFION PROVISIONS. 10 DAYS FOR NONPAY` H N 1 01: PREMIUM. XX
CERTIFICATE HOLDER CANCELLATION
2660597
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF FORT COLLINS
DATE THEREOF, THE ISSUING INSURER WILL MNEQk90T7q MAIL 10 DAYS WRITTEN
215 N. MASON STREET
FORT COLLINS CO 80524
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, XLXX6iLV9kNTX D%X$MxAXIX
"MXXW)QNX-K10 X13 tX�K9fNNX�WONSpNXE sfil3� X X �d1SX9R
h�9YXE$
AUTHORIZED REPRESEf8TAT10 �9
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AUUKU ZS(ZUU'I/UO) <..Alll,c„mmmnlslcdmm<Produ<or'svnlon nbovo xnd enomyINSTEor. ___ 0 AY;ORD CORPORATION 1988