HomeMy WebLinkAbout389317 PROCTOR ENGINEERING GROUP - INSURANCE CERTIFICATE (4)ACORD
CERTIFICATE
DAT 06-252008YY)
OF LIABILITY INSURANCE 1
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
PAYCHEXAGENCY INC.
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
150 SAWGRASS DRIVE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ROCHESTER, NY14620-4648
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Phone(877)362-6785
Fax 877)677-0447
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: TRAVELRS INDEMNITY COMPANY
OF CT
PROCTOR ENGINEERING LTD
INSURER S:
418 MISSION AVENUE
WSURERC:
j
SAN RAFAEL, CA 94901
INSURER D�_
INSURER E:
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.
POLICY
EFFECTIVE
INSR
ADVL
DATE
POLICY EXPIRATION
LTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
MM/ODNY
DATE MWDDIYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
DAMAGE TO RENTED
$
❑ COMMERCIAL GENERAL LIABILITY
PREMISES Ea occurrence
❑ CLAIMS MADE ❑ OCCUR
MED EXP (Any oneperson)$
❑
PERSONAL &ADV INJURY
$
❑
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
❑ POLICY ❑ PROJECT ❑ LOC
COMBINED SINGLE LIMIT
$
AUTOMOBILE LIABILITY
Ea accident
❑ ANY AUTO
BODILY INJURY
$
❑ ALL OWNED AUTOS
(Per person)
❑ SCHEDULED AUTOS
❑ HIRED AUTOS
BODILY INJURY
$ j
❑ NON -OWNED AUTOS
Per accident
❑
PROPERTY DAMAGE
$
❑
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
❑ ANY AUTO
OTHER THAN EA ACC
$
❑ .-_...__.___.___._..___
AUTO ONLY: AGG
$
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
❑ OCCUR ❑ CLAIMS MADE
AGGREGATE
$
❑ DEDUCTIBLE
$ ,
❑ RETENTION $
$
WORKERS COMPENSATION AND
® WC STATU- ❑ OTHER
EMPLOYERS' LIABILITY
TORY LIMITS
A
ANY PROPRIETOR/PARTNER/EXECUTIVE
UB-4713M765
07-01-2008
07-01-2009
E.L. EACH ACCIDENT
$ 1,000.000
OFFICER/MEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
Iiyes, desPROVISIONS below: be under
SPECIAL PRO
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
OTHER
i
I
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
IN THE EVENT OF NON-PAYMENT OF PREMIUM, ONLY TEN(10) DAYS NOTICE OF CANCELLATION SHALL BE GIVEN,
I
CERTIFICATE HOLDER
CANCELLATION
CITY OF FORT COLLINS
PURCHASING DIVISION
PO BOX 580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE I
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT I
FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
FORT COLLINS, CO 85022
INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE — Kara Moore
VA
ACORD 25 (2001/08) 0 ACORD CORPORATION 1998