HomeMy WebLinkAbout384515 WILDCAT CIVIL SERVICES INC - INSURANCE CERTIFICATEACORO° F DATE (MMIDDNYYY)
CERTIFICATE OF LIABILITY INSURANCE 1/1/2011 1 6i2i2010
PRODUCER Lockton Companies, LLC-1 Kansas City THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
444 W. 47th Street, Suite 900 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Kansas City MO 64112-1906 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
(816) 960-9000 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURED WILDCAT CIVIL SERVICES
1312696 ATTN: TIMOTHY L. CARROLL
7915 CHERRYWOOD LOOP
KIOWA CO 80117
COVFRAGFS SHEC001 SA
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: Zurich American Insurance Company
16535
INSURER B : American Guarantee and Liab. Ins. Co.
26247
INSURER C :
INSURER D :
INSURER E :
THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING
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
ADD'L
POLICY EFFECTIVE
POLICY EXPIRATION
LTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE (MM/DD/YY)
DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE FS-1 OCCUR
GLO 5945722-01
I/1/2010
1/1/2011
DAMAGE TO RENTED
PREMISES Ea occurence
$ 300 000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 21000,000
GENERAL AGGREGATE
$ 4,000,000
_
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 4,000,000
PRO -
POLICY X I JECT LOC
B
AUTOMOBILE
LIABILITY
ANY AUTO
BAP 5945725-01
1/1/2010
1/1/2011
COMBINED SINGLE LIMIT
(Ea accident)
$ 2,000,000
X
BODILY INJURY
(Per person)
$ XXXXXXX
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$ XXXXXXX
HIRED AUTOS
NON -OWNED AUTOS
X
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
OCCUR ❑ CLAIMS MADE
AGGREGATE
$ XXXXXXX
UMBRELLA
NOT APPLICABLE
$ XXXXXXX
$ XXXXXXX
DEDUCTIBLE FORM
$ XXXXXXX
RETENTION $
A
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE HN
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
WC 5945727-01
WC 5945728-01
1/1/2010
1/1/2010
I/1/2011
1/1/2011
X WC STATU- OTH-
TORY LIMITS I ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: 7106 CURED -IN -PLACE PIPE SANITARY SEWER STORMWATER MAINS REHABILITATION. THE CITY, ITS OFFICERS, AGENTS AND
EMPLOYEES ARE NAMED AS ADDITIONAL INSURED ON GENERAL AND AUTOMOBILE LIABILITY AS PER WRITTEN CONTRACT.
CITY OF FORT COLLINS
FINANCIAL SERVICES
PURCHASING DIVISION
215 NORTH MASON STREET
2ND FLOOR, 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 MXe&(XXM MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, NXXXQQKMXXl =NX
AUTHORIZED
ACORD 25 (2009/01)
988-2009 jCC6k1D CORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD
For auestions reaardino this certificate, contact the number listed in the 'Pro ucer' section above and soecifv the client code'SHECOOV.