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HomeMy WebLinkAbout109888 INSITUFORM TECHNOLOGIES INC - INSURANCE CERTIFICATE (4)ACORD. CERTIFICATE OF LIABILITY INSURANCE 7/1/2010 DATE (MM/DD/YYYY) 6/29/2009 PRODUCER Lockton Companies,LLC-1 St. Louis Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 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 Insituform Technologies, Inc. INSURER A: Liberty Mutual Fire insurance Company (64) 23035 1041932 17988 Edison Avenue Chesterfield MO 63005 INSURER B : Liberty Insurance Corporation (64) 42404 INSURER C : INSURER D : INSURER E : COVERAGES INSTE02 29 THIS CERTIFICATE OF N5URANGE 00E5 NOT WN511I U I It -A GUN I RAG I eat THE Rt ISSUING INSURERS AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. 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'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurence $ 350,000 A X COMMERCIAL GENERAL LIABILITY TB2-641-004218-039 7/1/2009 7/1/2010 CLAIMS MADE Fx_1 OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 21000,000 A X Independt Contractor BROAD FORM PD/CONTRACT X XCU GENERAL AGGREGATE $ 41000,000 A PER PROJECT AGG. CAP $20M GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 PRO - ri POLICY X JECT LOC A AUTOMOBILE LIABILITY ANY AUTO AS2-641-004218-029 7/1/2009 7/1/2010 COMBINED SINGLE LIMIT (Ea accident) $ 2,000,000 X BODILY INJURY (Per person) $ XXXXXXX ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ XXXX��X HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ XXXXXXX GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXxxXX ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX AUTO ONLY: AGG $ XXXXXXX EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX OCCUR CLAIMS MADE �� $ XXXxxx UMBRELLA NOT APPLICABLE $ )Cxxxxxx DEDUCTIBLE FORM $ XXXXXXX RETENTION $ B WORKERS COMPENSATION AND WA7-64D-009004449 7/1/2009 7/1/2010 X I ORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 B EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? WC7-641-004218-019 (WI & OR) 7/1/2009 7/1/2010 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 It yes, describe under NO SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSA/EHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: P-1022, CURED -IN -PLACE PIPE SANITARY AND STORM SEWERS. THE CITY OF FORT COLLILNS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSUREDS UNDER GENERAL LIABILITY AND AUTOMOBILE LIABILITY AS REQUIRED BY WRITTEN CONTRACT, BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE NAMED INSURED'S OPERATIONS. EXCEPTION TO CANCELLATION PROVISIONS: 10 DAYS FOR NONPAYMENT OF PREMIUM. XX GANGtLLA Lbbuou / SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER WILL e*)te4pM)TX MAIL 10 DAYS WRITTEN 215 N. MASON STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, ]✓�l%�{�{I�[L1QIjQQ(Q(,gQ}$�( FORT COLLINS CO 80524 X � X X� p X �q xr3&I X k 7$x0e) AUTHORIZED REPRESE ArnRn 2-,; r2nnimm Fnr rrnestions reoardino this certificate. contact the number listed in the 'Producer' section above and soecitvt e'INSTEOP. © A ORD CORPORATION 19RR