HomeMy WebLinkAboutENVIRONMENTAL ABATEMENT SOUTHWEST - INSURANCE CERTIFICATE (4)ACORp_,. CERTIFICATE OF LIABILITY INSURANCE OP ID DC DATE(MM/DD/YVVV)
ENVIR13 1 11 18 08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Six & Geving Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3630 Sinton Road, Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Colorado Springs CO 80907-5034
Phone: 719-590-9990 Fax:719-590-9992 INSURERS AFFORDING COVERAGE NAIC#
-E- - ---..__ _ ..__—..
INSURED Environmental Abatements -
e,... �-T........ a. r...,_ .1,1 -_-______ INSURER A: Arch $TJeC1a1tV IRS CO
C; EASW-VA INSURERS: All Insurance Group_ _ 42579
Place LLC INSURERC Pinnacol Assurance 41190
Place INSURER D: Argonaut Insurance Compan
CO 80916 - - -- -__
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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.
SR
LTR
6D___
NSR
____ _.
TYPE OF INSURANCE
______.__.._..._ ._-
POLICY NUMBER
—_
POLICY EFFECTIVE
GATE MM/DDIVV
-EXPIRATION
DATE MMIDD/YY
LIMITS
GENERAL LIABILITY
__
EACH OCCURRENCE
$2,000,000
A
.X COMMERCIAL GENERAL LIABILITY
-_CLAIMS MADE uOCCUR
12EMP43438-04
11/27/08
11/27/09
_.
_DAMAGFT(SRENTED.
pREMISESEaoccurence
_._ .._._.
$50,000
MED EXP(Any one person)
$5,000
X INCL POLLUTION/
PERSONAL&AOV INJURY
OOO, QQQ
ASBESTOS/LEAD
-- ---._
GENERAL AGGREGATE
-$2,
----
$2, QQQ.000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
__._....___.
$2,000,QQ0
X POLICY jECof 17 LOC
Pollution
—_..._-_
2,000 000
B
AUTOMOBILE
X
LIABILITY
ANY AUTO
ACP7570805635
02/02/08
02/02/09
COM
(Ea accdeD)INGLEUMIT
$1,000,000
-
ALL OWNED AUTOS
SCHEDULED AUTOS
—---�--
BODILY INJURY
(Per person)
—--------
$
BODILY INJURY
(Per accident)
$
HIREDAUTOS
NON -OWNED AUTOS
—
PROPERTY DAMAGE
(Per accident)
$
-----------
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: ASS
$
ANY AUTO
- —
$
EXCESS/UMBRELLA LIABILITY
OCCUR CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
DEDUCTIBLE
$
$
RETENTION $
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANVPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
DI! es, describe under
SPECIAL PROVISIONS below
4028665
WC47685825843:TX&
04/01/08
04/01/08
04/01/09
04/01/09
X TORYLIMITS ER
--- ------
E.L. EACH ACCIDENT
---------_
$1,000,000
E.L. DISEASE- EA EMPLOYEE$
-------------
1, 000, 000
------..--
E.L. DISEASE - POLICY LIMIT
$1,000,000
OTHER
B
Inland Marine
ACP7570805635
02/02/08
02/02/09
Contr EDp $303,742
B
Prop-RC/Spec Form
ACP7570805635
02/02/08
02/02/09 1
Bldg/Cont $663 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Proof of Insurance. Job: 500 Riverside Asbestos Abatement. Cert holder is
named General Liability Additional Insured. fax:970-221-6707
FORTC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOP
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
215 N Mason St, 2nd Floor
Fort Collins CO 80524 REPRESENTATIVES.
25 (2001108) 0) ACORD
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.
AGUKU 25 (20011W)