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Home My WebLink AboutSOURCE ENVIRONMENTAL AET ENVIRONMENTAL - INSURANCE CERTIFICATE�7 ® CERTIFICATE OF LIABILITY INSURANCE OP ID Bw DATE(MM/DD/YYYY) SOUE001 06/02/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Henry Ham Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O. Box 100547 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 645 E. Evans Ave. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver CO 80250 Phone: 303-744-1341 Fax: 303-744-0654 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Liberty Insurance Services INSURER B: Pinnacol Assurance Source Environmental Inc. INsuRERc: Argonaut Insurance Company dba: AET Environmental g P y 14 Lakeside Lane INSURERD: Travelers Insurance Denver CO 80212 INSURER E: Arch Insurance Company 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. LTR ADDT NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 PREMISES(Eaoccurence) $ 100,000 A X COMMERCIAL GENERAL LIABILITY UVE-DE-102108-019 06/01/09 06/01/10 CLAIMS MADE FJ7I OCCUR MED EXP (Any one person) s25,000 PERSONAL BADVINJURY $ 1,000,000 X Professional UVE-DE-102108-019 06/01/09 06/01/10 UVE-DE-102108-019 X Pollution GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $2,000,000 POLICY X PERO LOC JCT E AUTOMOBILE LIABILITY ANY AUTO FBCAT0129900 06/01/09 06/01/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ Pollution Llab X MSC-90 GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ 5,000,000 A X OCCUR F-1 CLAIMS MADE UME-DE-102109-019 06/01/09 06/01/10 AGGREGATE $5,000,000 $ DEDUCTIBLE $ X RETENTION $ 10 , 000 B C., WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N ANY PROP RIETOR/PARTNER/EXECUTIVy--7 OFFICER/MEMBER EXCLUDED? LJ (Mandatory In NH) If yes, describe under SPECIAL PROVISIONS below 3445583 47718828242(TX,FL,GA,NV) 05/01/09 05/01/09 05/01/10 -05/01/10 X TORY LIMITS X 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 Hired Physical Dmg FBCAT0129900 06/01/09 06/01/10 Comp/Coll $80,000 E I Business Property 660-5906L866 08/28/08 08/28/09 Contents* $96,820 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITF002 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 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 City Of Fort Collins REPRESENTATIVES. P O BOX 580. AUTHO I Fort Collins CO 80522 Ck nrnRn 2s (9nn9inii ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of 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 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. ACORD 25 (2009/01)