HomeMy WebLinkAboutAYRES ASSOCIATES - INSURANCE CERTIFICATE (5)Client#:14106 ` IL
AYRESASSO
ACORUM CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/D
12/30/08DmYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
WAUSAU SIGNATURE AGENCY
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
PO BOX 8017
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
WAUSAU, WI 54402-8017
715 845-5211
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: Wausau Underwriters Insurance Co..
26042
AYRES ASSOCIATES INC
PO BOX 1590
EAU CLAIRE, WI 54702-1590
INSURER B:
INSURER C:
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.
INSR
LTR
DD'
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MMIDD/YY
LIMITS
A
GENERAL LIABILITY
YYJY91503188069
01/01/09
01/01/10
EACH OCCURRENCE
$1 000000
MERCIAL GENERAL LIABILITY
MADE 51OCCUR
if
DAMAGE TO RENTED
PREMISE E o currenceCLAIMS
$300000
MED EXP (Any one person)
$5000
PERSONAL & ADV INJURY
$1 00U 000
GENERAL AGGREGATE
s2,000,000
_
kGEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s2,000,000
POLICY n PRO LOC
JECT
A
-
AUTOMOBILE
LIABILITY
ANY AUTO
ASJY91503188029
01/01/09
01/01/10
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,0U0
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
-
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
$
$
DEDUCTIBLE
$
RETENTION $
A
WORKERS COMPENSATION AND
WCJY91503188049
01/01/09
01/01/10
X INCSTATU- OTH-
FIR
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEE
$100,000
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
REGARDING PROJECT P959-CONSULTING ENGINEERING SERVICES NORTH COLLEGE
DRAINAGE IMPROVEMENT PROJECT AND FUTURE WATER, WASTEWATER AND STORMWATER
FACILITIES CAPITAL IMPROVEMENTS
THE CITY OF FORT COLLINS IS AN ADDITIONAL INSURED ON THE GENERAL LIABILITY
(See Attached Descriptions)
CITY OF FORT COLLINS
PURCHASING DEPARTMENT
PO BOX 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ 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, ITS AGENTS OR
AUTHORIZED REPRESENT
AGORD 25 (2001/08) 1 of 3 #M535840 ME1 0 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.
AGUKD Z5-5 (ZOO1/OB) 2 of 3 #M535840
DESCRIPTIONS (Continued from Page 1)
WITH RESPECT TO LIABILITY ARISING OUT OF OPERATIONS PERFORMED BY THE NAMED
INSURED.
AM5 Zb.3 (MI/Ut3) 3 Ot 3 #M535840
I�'JrTXy��Yi7
ACORD- CERTIFICATE OF LIABILITY INSURANCE
1DATE
2/30/08DIYYYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
WAUSAU SIGNATURE AGENCY
PO BOX 8017
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
WAUSAU, WI 54402-8017
715 845-5211
INSURERS AFFORDING COVERAGE
NAIC #
INSURED -
INSURER A: Wausau Underwriters Insurance Co.
26042
AYRES ASSOCIATES INC
INSURER B:
PO BOX 1590
EAU CLAIRE, WI 54702-1590
INSURER C: -
INSURER D:
INSURER E:
rnvGoer_Gc
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
LTR
ADD '
NSR
-
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YY
POLICY EXPIRATION
DATE MMIDD/YY
LIMITS
A
GENERAL LIABILITY
YYJY91503188069
01/01/09
01/01/10
EACH OCCURRENCE
$1 000 000
DAMAGPRE SE SO a oec ErD nc
$300000
X COMMERCIAL GENERAL LIABILITY
MED EXP (Any one person)
$5 OOO
CLAIMS MADE 5_1 OCCUR
PERSONAL & ADV INJURY
$1 OOO OOO'
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s2,000,000
POLICY PRO-
JECT LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
ASJY91503188029
01/01/09
01/01/10
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$ -
ALL OWNED AUTOS
SCHEDULED AUTOS
-
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
-
$
RETENTION $
A
WORKERS COMPENSATION AND
WCJY91503188049
01/01/09
O1IO1I1O
OTH-
X WORYC MITS ER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
E.L. EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEE
$100,000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
s500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
PROJECT: CITY OF FORT COLLINS CONSULTING ENGINEERING SERVICES. NORTH
COLLEGE DRAINAGE IMPROVEMENT PROJECT AND FUTURE WATER, WASTE WATER AND
STORM WATER FACILITIES CAPITAL IMPROVEMENTS - PROJECT #P959. THE CITY OF
FORT COLLINS IS INCLUDED AS AN ADDITIONAL INSURED UNDER THE GENERAL
(See Attached Descriptions)
L;tK I IrK;A I t MULLItK
CITY OF FORT COLLINS
PURCHASING DEPT
PO BOX 580
FORT COLLINS, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3n. 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, ITS AGENTS OR
AUTHORIZED
ACORD 25 (2001/08) 1 of 3 #M535840 ME1 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 25-S (2001108) 2 of 3 #M535840
DESCRIPTIONS (Continued from Page 1)
LIABILITY POLICY PER GLO566 AND AS LIMITED INSURED UNDER THE AUTO PER
CA2048.
AMS 25.3 (2001108) 3 of 3 #M535840