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AON RISK SERVICES CENTRAL INC - INSURANCE CERTIFICATE
'4 �® CERTIFICATE OF LIABILITY INSURANCE DA 07/ 6122010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER Aon Risk Services Central, Inc. Pittsburgh PA office CONTACT NAME: PHONE (866) 283-7122 FAX (847) 953-5390 (1C. No. Et): (A/C. No.): E-MAL ' Dominion Tower, loth Floor 625 Liberty Avenue Pittsburgh PA 15222-3110 USA 9 PRODUCER 570000027699 CUSTOMER ID M INSURER(S) AFFORDING COVERAGE NAIC # INSURED Michael Baker J r. , Inc. 355 Onion Blvd, Suite 200 INSURERA: Syndicate #2623 Lloyds of London 0005FI INSURER B: 01SURERC: Lakewood Co 80228 USA INSURER D: INSURER E: INSURER F: GOVERAGE5 CERTIFICATE NUMBER: 570039542684 REVISION NUMBER. THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limits shown are as requested INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICYNUMBER POLICY EFF MMIDDIYYYY) POLICY EXP (MMIDDIYYYYJ LIMITS GENERAL LIABILITY EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY DAMAGEO RE NTED PREMISES Ea occurrence CLAIMS -MADE ❑ OCCUR MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG POLICY PRO-JECT Ll LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY( Per person) ANY AUTO ALL OWNED AUTOS BODILY INJURY (Per accident) SCHEDULEDAUTOS PROPERTYDAMAGE HIRED AUTOS Per accident NON OWNED AUTOS UMBRELLA LIAR EACH OCCURRENCE EXCESS LIAB HOCCUR CLAIMS -MADE AGGREGATE DEDUCTIBLE RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILffV YIN ANY PROPRIETOR / PARTNER / EXECUTIVE WC STATU- OTH TORY LIMITS E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE -POLICY LIMIT A E&O-ProfLiabPri QK1002675 06/30/2010 06/30/2011 Excess Professional $5,000,000 SIR applies per policy ter s & Condit ons DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mare space is required) For Named Insured Only: Attn:Steve McQuilkin. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE Attn: Steve McQuilkin PO Box 580 �n ����:�Q�c r�srtteoxD �LtaG ✓na Fort Collins CO 80522 USA ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD