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HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE CERTIFICATEF�ATE MWDDIYYYY) A CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 03/(02/2009 PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis HRH HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. 0. Box 305191 Nashville, `TN 372305191 INSURED JACO Environmental, Inc. PO Box 1478 Snohomish, WA 98291 COVFRAGFR INSURERS AFFORDING COVERAGE NAIC# INSURERA:Lexington Insurance Co. 19437-000 INSURERB:St. Paul Fire and Marine Insurance Compan 24767-001 INSURERC:Commerce and Industry Insurance Company 19410-001 INSURERD:American International Specialty Lines In 26883-002 INSURER E: 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' NSR TYPE OFINSURANCE POLICY NUMBER POLICY EFFECTIVE D TEfMWDDrfYM POLICY EXPIRATION DATE M DD YY) LIMITS A GENERAL LIABILITY 7360287 9/15/2008 9/15/2009 EACH OCCURRENCE $ 2,000,000 I X COMMERCIAL GENERAL LIABILITY - CLAIMS MADE OCCUR - - PREMI ETORENTED PREMISES Ea occurence $ 1,000,000 MED EXP (Anyone person) "$ PERSONAL& ADV INJURY $ 1,000,000 X WA Stop Gap Included X $10, 000 Deductible GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 PRO• 7 LOC X POLICY F AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY _ (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EAACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS/UMBRELLA LIABILITY QK09400702 9/15/2008 9/15/2009 EACHOCCURRENCE $ 5,000,000 r AGGREGATE $ 5,000,000 X OCCUR CLAIMS MADE $ $ DEDUCTIBLE $ X RETENTION $ 10 000 L, C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED, '�_ CA WC5317404 AOS WC5317405 - - 2/28/2009 2/28/2009 9/15/2009 9/15/2009 X TNRYLAMIT .OTH ER E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) - If yes, describe under SPECIAL PROVISIONS below - E.L. DISEASE -POLICY LIMIT $ 1,000,000 D OTHER 1361078 9 15 2008 9/15/2009 Pollution Legal Liability $1,000,000 Per Incident including BI/PD & Cleanup $2,000,000 Aggregate , 25 000 Deductible Each Incident DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS The Workers' Compensation 'AOS' policy covers Oregon, Nevada, Utah, New Mexico, Colorado, Idaho and Illinois only. GEH 1 IFIGATE HOLDER CANCELLATION City of Fort Collins Purchasing Division Attn: Christine Patterson -Jarvis 700 Wood Street Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE �,iioti►�� - �i AGOHD25(2009/01) Coll:2630440 Tpl:895457 Cert:12199587©1988-2009ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Page 2 of 2 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 This Certificate of Insurance 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. 4CORD25(2009/01) C011:2630440 Tp1:8,95457 Cert:12199587