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HomeMy WebLinkAbout330448 JACO ENVIRONMENTAL - INSURANCE CERTIFICATE (6)TE A� CERTIFICATE OF LIABILITY INSURANCE page 1 of 3 091 7/20 0 PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis of Seattle, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 305191 Nashville, TN 37230-5191 INSURED JACO Environmental, Inc. PO Box 1478 Snohomish, WA 98291 r*Te1T1V=17Tcl=W INSURERS AFFORDING COVERAGE INSURERA:Zurich American Insurance INSURERB:Steadfast Insurance Compa INSURER C: INSURER D: INSURER E: NAIC# 16535-001 26387-001 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' N TYPEOFINSURANCE POLICYNUMBER POLICYEFFECTIVE DATE M DD YYY POLICY EXPIRATION DATE MM DD YYV LIMITS A X GENERAL LIABILITY GL0672515900 9/15/2010 9/15/2011 EACHOCCURRENCE $ 2,000,000 PREMISES(Eaoccurence $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE n I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL& ADV INJURY $ 1,000,000 R WA Stop Gap Included X $10, 000 Deductible GENERAL AGGREGATE $ 2,000,000 G ENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 LlPOLICY X PRO LOC' AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULEDAUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON-OWNEDAUTOS PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EAACC $ ANYAUTO $ AUTOONLY: AGG EXCESS/UMBRELLA LIABILITY EACHOCCURRENCE $ OCCUR F—ICLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE $. RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY V/N ANY PROPRIETOR/PARTNER/EXECUTIVE � - � WC STATU- OTH- TORY LIMI T ER E.L. EACH ACCIDENT $ ' OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ B OTHER CPL672516200 9 15 2010 9 15 2011 Pollution Legal Liability $5,000,000 Per Incident including BI/PD & Cleanup $5,000,000 Aggregate 25 000 Deductible Each Incident DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS See Attached. le4a:f1lalyLlh40LI1J3:1 City of Fort Collins Attn: Opal Dick 700 Wood St. Fort Collins, CO 80522 UAN(:tLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 ACORD 25 (2009/01) Coll:3127890 Tpl:1146369 Cert:14686390©1988-2009ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD r * DATE Willis CERTIFICATE OF LIABILITY INSURANCE page 2 of 3 09/17/2010 PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis of Seattle, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 26 Century Blvd. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 305191 Nashville, TN 37230-5191 INSURERS AFFORDING COVERAGE NAIC# INSURED JACO Environmental, Inc. INSURERA:Zurich American Insurance Company 16535-001 PO Box 1478 INSURERB: Steadfast Insurance Company 26387-001 Snohomish, WA 98291 INSURER C: INSURER D: INSURER E: UCJUMlr IIVIYVr Vr=MA I1UNWLVI.A I 1UNWYCMULCWCAILUWUNI AUUCUDT CIYUVISJCM CIY 1/J 1'CVIAL rISV YIJIV IY� Professional Liability Carrier: Executive Risk Indemnity Inc. Policy Number: 81996690 Effective Date: 09/15/2010 Expiration Date: 09/15/2011 Limits: $1,000,000 Each Claim $1,000,000 Aggregate $ 15,000 Retention, Each Claim IIt is agreed that City of Fort Collins and its officers, agents and employees are included as Additional Insureds as respects to General Liability where required by written contract. Coll:3127890 Tpl:1146369 Cert:14686390 Page 3 of 3 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. ACORD25(2009/01) C011:3127890 Tp1:1146369 Cert:14686390