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HomeMy WebLinkAboutBIO KLEAN WORLD ENVIRONMENTAL - INSURANCE CERTIFICATE (3)8/1/2008 4:22 PM FROM: JCB TO: +1 (970) 2216707 PAGE: 001 OF 002 ACORD,M CERTIFICATE OF LIABILITY INSURANCE DATE(MMNDNYYY) 08/01/2008 PRODUCER (970) 484-2805 John C. Beckett & Associates, Inc. 220 Smith Street Ft. Collins CO 80524- 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 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Bio Klean World Environmental, Inc. 145 West Swallow Road, Ste A2 Fort Collins CO 80525-2500 INSURER A. BURLINGTON INSURANCE CO INSURER B. INSURER INSURER D. INSURERS 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. INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DDNY) DATE(MMNDNY) LIMITS A GENERAL LIABILITY 21OB522378 07/27/2008 07/27/2009 EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY PREMI ESES S( RENTEDEd$ PREMI 100,000 CLAIMS MADE FRIOCCUR / / / / MED EVA(Any one person) $ 5,000 PERSONAL &ADV INJURY $ 500,000 GENERAL AGGREGATE $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OPAGG $ 1,000,000 X POLICY JECT LOC AUTOMOBILE LIABILITY NO COVERAGE / / / / COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY ALL OWNED AUTOS / / / / SCHEDULED AUTOS (Per person) $ HIRED AUTOS NOWOWNED AUTOS / / / / BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTOONLY- EAACCIDENT $ OTHER THAN EA ACT $ ANY AUTO NO COVERAGE / / / / $ AUTO ONLY. AGG EXCESS/UMBRELLA LIABILITY NO COVERAGE / / / / EACH OCCURRENCE $ OCCUR CLAIMSMADE AGGREGATE $ 5 DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND NO COVERAGE IITORVLIMITS OER EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ OFFICER/MEMBER EXCLUDED? / / / / If yes, describe under SPECIAL PROVISIONS below EL.DISEASE -POLICY LIMIT $ OTHER NO COVERAGE DESCRIPTION OF OPERATIONS&OCATIONSNEHICLESiEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION ( ) - (970) 221-6707 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT CITY OF FORT COLLINS FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE ADMINISTRATIVE SERVICES INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE P O BOX 580 FORT COLLINS CO 80522-0580 ACORD 25 (2001/08) ©ACORD CORPORATION 1988 to INS025(0108). 05 ELECTRONIC LASER FORMS ,INC .-(800)327-0545 Page 1of2 8/1/2008 4:22 PM FROM: JCB TO: +1 (970) 2216707 PAGE: 002 OF 002 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 25 (2001/08) tl- INS025 (ofoa).os Page 2 of