HomeMy WebLinkAbout478600 ROCKY MOUNTAIN ENVIRONMENTAL SERVICES - INSURANCE CERTIFICATE (2),e,R p°° PDATED
CERTIFICATE OF LIABILITY INSURANCISU_RAN
DATE(MMIDD/YYYY)
10/05/2010
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELYOR 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, thepolicy(les) 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 endorsemen s .
PRODUCER
NhAMEACT KAREN OCO_NNELL
BONDING & INSURANCE SPECIALISTS AGENCY, INC.
FAX
PHJCN& E,d)_ 708-598-5355 No : 708-598-6686
9340 S. HARLEM AVENUE
_
'ADDAR K_O_CONNELL@BISA-INC.COM
BRtDGEVIEW, IL 60455
HOOK ss:
_
_ INSURER(S) AFFORDING COVERAGE
NAIC #
IN CALIFORNIA, DBA BONDS AND INSURANCE SERVICES; LIC.90795M
INSURER A ARCH SPECIALTY INSURANCE COMPANY
-
_
INSURED
STINKING D/B/A ROCKY MOUNTAIN ENVIRONMENTAL
-
INSURER B:
-- —
INSURER C:
SERVICES; AVIR ENVIRONMENTAL LLC; 100% DRY
2995 S. FOX STREET
INSURER D__
ENGLEWOOD, CO 80110
INSURER E;_
INSURER F:
t+Vvtr%AVCJ L.tKllr-Il.Alt NUMtytK: 1UU/U4 KEVISIUN NUMBER:
THIS IS TO CERTIFYTHAT 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_ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INgR
LTR
TYPE OF INSURANCE
AD L
INSPR
UBR
WVD
POLICY_ NUMBER
POLICY EFF.
;(MM(DD/YYYY
POLICY FJ(P
MM/DD/YY`{1')
-- -- --
LIMITS
-
A
GENERAL LIABILITY
X'. COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE LX 1 OCCUR
X 'CONTRACTORS POLLUTION
++AR&IA#- ----
12 EMP 71737 01
_---
10/02/10
10/02/11
EACH OCCURRENCE
DAMA6E•T� RENT�IS--
PREMISES (Ea occurrence)
S 1,000,000
$ �50,000
MED EXP (Any one perso'n) _
$_ 590
PERSONAL ADV INJURY
_
$ 1.000.000
.1,._---.-.-
X
ASSESTOSAJ AD OPS
GENERAL AGGREGATE
$ 2,000,000
_-
GENT AGGREGATE LIMIT APPLIES PER:
X POLICY_ JEC �1LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
`PER CLAIM
_
$ 1,000,000
AUTOMOBILE
_
LIABILITY
ANY AUTO
AU78, ED SCHEDULED
HIREDAUTOS NON -OWNED
AUTOS
-� �----
—�-�
(Ea accide�nq
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
W(5pER1Y'DAMAGE
(Per accident)
$
-'---�------
$
$
_
UMBRELLA LIAR
EXCESS LIAB
I
OCCUR
CLAIMS -MADE
-
EACH OCCURRENCE
v
$
_
AGGREGATE -�
-
$
DED RETENTION $ -W---
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNER/EXECUTNE(—1
I jFICE .11EIER EXCLUDED? ' �J
(Mandatory NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
_ -
- —
NIA
-----'_--
-----..-
_
ATT((77--j OTH-
�._-- TORY LIMITS.(_] ER
E.L. EACH ACCIDENT
.-_..-._
$
E.L. DISEASE - EX EMPLOYEE
--
S
E-L DISEASE - POLICY LIMIT
$
/J,
-
CONTRACTORS POLLUTION LIABILITY
MOLD ABATEMENT• CLAIMS MADE FORM
PROFFSSIONAI I IARIt MY - CI AIMS MAOF FORM
��-
12 EMP 7173701
_
10/02/10
10/02/11
---
$t,000,-- ---- R CLAIM --
$1,000,0D0 - MOLD AGGREGATE
ST nnn non - PFR CI AIM
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Addidonal Remarks Schedule, it more space is required)�-
ALL PROJECTS DONE DURING THE CAPTIONED POLICY TERM.
THE CERTIFICATE HOLDER IS ALSO NAMED AS AN ADDITIONAL INSURED UNDER THE GENERAL LIABILITY POLICY.
CITY OF FT. COLLINS
ATTN: JOHN STEPHEN
PURCHASE DEPARTMENT
P.O. BOX 280.
FT. COLLINS, CO 80522
.Rol
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
CORPORATION. All rights -reserved.
AUUKU 25 (201 U105) The ACORD name and logo are registered marks of ACORD