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Home My WebLink About162366 CARL WALKER INC - INSURANCE CERTIFICATE (4)A�� ® CERTIFICATE OF LIABILITY INSURANCE io/7/2010 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-ISSUINGANSURER(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 art endorsement. A statement on this certificate"does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER:-. e -.: ..... .: ...:... _.......- : Professional Concepts Insurance 1127 South Old US Highway 23 NAME: CONTACT Tracy Beville A`PH- ExtI- (800) 969-4041 a No: (800)969-4081 ADDRIESS:tbeville@pciaonline.com PRODUCER 00001460 CUSTOMER ID N INSURE S AFFORDING COVERAGE NAIC # Brighton MI 4 8114 - 98 61 INSURED INSURERA:Hartford Casualty Insurance,Co 29424 INSURERB:Hartford Underwriters Ins. Co. 30104 CARL WALKER, INC. INSURERCXL Specialty Ins. Co. 37885 5136 LOVERS IN, STE 200 D: Suite 200 -INSURER INSURERS: KALAMAZOO MI 49002 1 INSURER.: COVERAGES CERTIFICATE NUMBERkll 10/11 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. ' INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WV POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR 35SBWRU0693 2/31/200912/31/2011 DAMAG TO PREM SES EaENTED occurrence $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL SADVINJURY .-$ 1,000,000 X x,C,U 35SBWUI2279 X Contractual Liability GENERAL AGGREGATE $ 2,000,006 - GEWL AGGREGATE' LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG' � $" 2,000,000 ` .. r ' "' "" " ' - 7X, . POLICY;[,, „.: PRO- * .. �LOC .. . , . $ ... . AUTOMOBILE LIABILITY . COMBINED SINGLE LIMIT'' (Ea accident). � $ 1,000,000 B X X ANY AUTO ALL OWNED AUTOS• SCHEDULED AUTOS HIRED AUTOS 5UEGAF3505 2/31/2009!12/31/2011 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ X NON -OWNED AUTOS Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAR CLAIMS -MADE DEDUCTIBLE $ $ A X RETENTION $ 10,000 5XHGXY9736 2/31/200912/31/2011 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE E OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N / A 5WEGPN3645 2/31/2009 2/31/2011 WC STATU- OTH rp E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 H yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1000 000 C Professional Liability PR9689186 0/15/200910/15/2011 $2,000,000per cllaim $2,000,000 aggregate DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project #: R320077037. City of Fort Collins is named as Additional Insured as respects to General -Liability only and. would apply to the above named project so long a required within a written contract. l7iC111a M-11�1111iUJ Vl-ii,/ City of Fort Collins Second Floor 215 North Mason Street PO Box 580 -Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cosgrove/DES ACORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025poo9og) The ACORD name and logo are registered marks of ACORD A� " CERTIFICATE OF LIABILITY INSURANCE io/�i2o10 ' 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'holdei. in lieu of such endorsement(s). PRODUCER .. _ _. __.. - ! - - Professional Concepts Insurance 1127 South Old US Highway 23 CONTACT Tracy Beville - - ---- " NAME: - - . AC yo Ext), (800) 969-4041 FAX No): (800)969-4081 DRESS:tbeville@pciaonline.com PRODUCER CUSTOMER I pOOO1460 INSURER(S) AFFORDING COVERAGE NAIC# Brighton MI 48114-9861 INSURED INSURERA:Hartford Casualty Insurance Co 9424 INSURERB:Hartford Underwriters Ins. Co. 130104 CARL WALKER, INC. INSURER C XL Specialty Ins. Co. 137885 5136 LOVERS IN, STE 200 INSURERD: INSURERE: Suite 200 INSURER F : KALAMAZOO MI 49002 COVERAGES CERTIFICATE NUMBERAll 10/11 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. INSR LTR TYPE OF INSURANCE ADDL N SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDM(YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY IMAGE TO ENTID ence PREMISES Ea occurrence $ 300,000 A CLAIMS -MADE _x1 OCCUR 35SBWRU0693 2/31/200912/31/2011 MEDEXP(Any one person) $ " 10-1000 PERSONAL BADVINJURY $ 1,000,000 X x,C,U 35SBWUI2279 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: "': PRODUCTS '-COMP/OPAGG $ 2 i 000, 000 ' "'" ' '" "` "" " "' _ .$. I , X POLICY.. . PRO- �� .. AUTOMOBILE LIABILITY _ .... .. :. "' COMBINED SINGLE LIMIT (Ea accident). : $': 1',000,,OQO B X X ANY AUTO. ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS - 5UEGAF3505 2/31/200912/31/2011 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ PIP -Basic $ X NON -OWNED AUTOS Uninsured motorist combined 1 $ 1, 000', 000 X UMBRELLA uAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAR DEDUCTIBLE $ $ A X RETENTION $ .10 000 35XHGXr9736 2/31/2009'2/31/2011 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA 5WEGPN3645 72/31/200912/31/2011 WC STATU- ITH- RV LIMIT$ E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EAEMPLOYEE $ 1,000,000 H yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 C Professional Liability PR9689186 [L0/15/2009 0/15/2011 $2,000,000per cllaim $2,000,000 aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B more space Is required) Project #: R32006017. City of Fort Collins is named as Additional Insured as respects to General Liability only and would apply to the above named project so long as required within a written contract. City of Fort Collins Attn: Second Floor 215 North Mason Street P. O. Box 580 Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Cosgrove/DES „ ` ��" `� a AGUKJ) Zb (ZUUVIUV) 'V IV?375-ZUUV AL;UKUS:UKI'UKA I IUN. All rlgnis reserve0. INS025 (200909) The ACORD name and logo are registered marks of ACORD