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HomeMy WebLinkAbout256950 ALLIED TUBE & CONDUIT - INSURANCE CERTIFICATE (2)Aco�o� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) (ram.1 9/27/2010 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 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 endorsements . PRODUCER CONTACT NAME: PHONE FAX Marsh, Inc. AJC No Ext : A/C No): E-MAIL 1166 Avenue of the Americas ADDRESS: PRODUCER CUSTOMER ID #: New York, NY 10036 INSURERS AFFORDING COVERAGE NAIC # Telephone (212) 345-5000 INSURED COMPANY A: CHARTIS CASUALTY COMPANY Allied Tube & Conduit COMPANY B: Commerce & Industry Ins Co 16100 S. Lathrop Avenue COMPANY C: Illinois National Insurance Co. Harvey, IL 60426 COMPANY D: Nat'l Union Fire Ins Co of Pittsburgh, PA United States COMPANY E: New Hampshire Ins. Co. COVERAGES CERTIFICATE NUMBER: 765612 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 SUER POLICY NUMBER POLICY EFF MIWDDIYYYY POLICY EXP MMIDDlYYYY LIMBS E GENERALLIABILITY GL 4360884 (Primary GL) 10/1/2010 10/1/2011 EACH OCCURRENCE $1,000,000.00 X COMMERCIAL GENERAL LIABILITY EN TED PREMISES Ea occurrence) $1,000,000.00 CLAIMS -MADE � OCCUR ME EXP (Any one person) $10,000.00 PERSONAL & ADV INJURY $1,000,000.00 OWNER'S & CONTRACTOR'S GENERAL AGGREGATE $2,000,000.00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP -OP AGG $2,000,000.00 POLICY PRO LOC D D D E AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS CA 3976576 (VA) CA 3976575 (AOS) CA 3976577 (MA) CA 3976624 (NH) (Primary AL) 10/1/2010 10/1/2010 10/1/2010 10/1/2010 10/1/2011 10/1/2011 10/1/2011 10/1/2011 OMBINEDSINGEL LIMIT"ACCMENT) NEWHAMPSHIRE COMB. SWGLELIMIT $1,000,000.00 $250.000 BODILY INJURY (Per person) BODILY INJURY (Peraccid ent) SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) X NON -OWNED AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAR CLAIMS -MADE DEDUCTIBLE kPR10DUCTS - COMP/OP AGG AapSHWEAS CONO-OSINnLE UW RETENTION $ A I3 C o E E E WORKERS COMPENSATION AND EMPLOYERS' LIABILITYMITS YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS below NIA WC 026149517(CT,GAPASC) WC 0-16149514 (FL) WC 026149516(MI) WCO26149513(CA) WC(126149518 (MA ND,NY,OH,WAWI.WY) WC 026149548(MN) WC 026149515(TX) WCO26149519 AOS 10/1/2010 1011/2010 101112010 10/1/2910 10/1/2010 10/1/2010 10/1/210 10/1/2010 10/1/2011 10/1/2111IQBY t0/11211I 1011/2011 10/1/2111 1011011 101112)11 10/112D11 X WC STATU- OTH- E.L. EACH ACCIDENT 2,000,000.00 E.L. DISEASE - EA EMPLOYEE $2,000,000.00 E.L. DISEASE - POLICY LIMIT $2,000.000.00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Rernarks Schedule, if more space is required) it, ,-_-m.=nna ,;i:h vha pniz• rr.-.-iai�,,. nt: <� ,<au _::_in:: is itrl,m,e :. ntt a]a :i.�,,.1 ,,,attr.e to gar _ei, , . rn„a, -r .,,r - r --- - .v-h vhe prl , m- _o] --- - - _tte p-1iry Frci rtrage a[[-r:1H_ _- i-.lan1 huntre] till - iv n...__r.1.:.rce ,:v_h aiata, cv n nit _ ev-ere] itv-= by =h, nnre] innurn] atvt -he 'it- - - Sna„e] -- Fnly nn pri'+.avun¢n] eb..l t5 , rs-enn .ni mt�h e]]v-1.:v.1 - Sv !. -� CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS 281 N. COLLEGE AVE P.O. BOX 580 FT.COLLINS, COLORADO80522-0580 United States ACOR1325 (2009109) 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 REPRESENTATIVE MARSH USA INC, BY: Franklin Hallodc, Global Marne David K-q. Casuafty Program Transit Program ©1988-2W9 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registeradmarks of ACORD ?or questions regarding this certificate contact: Theresa Pinedo (Email: tpinedona=_iedtt+b a Phone: 800 882 55t3) ADDITIONAL INFORMATION 765612ATE NUMBER PRODUCER Marsh, Inc. 1166 Avenue of the Americas New Yak, NY 10036, Telephone (212) 345-5000 INSURED Allied Tube & Conduit 16100 S. Lathrop Avenue Harvey, IL 60426 United States TEXT CERTIFICATE HOLDER CITY OF FORT COLLINS 281 N. COLLEGE AVE P.O. BOX 580 FT.COLLI NS, COLORADO 80522-0580 United States COMPANIES AFFORDING COVERAGE I THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY ENDORSEMENT This endorsement, effective 12:01 A.M. 10/01/2010 forms a part of Policy No. GL 436-08-84 issued to Tyco International Management Company, LLC by New Hampshire Insurance Company ADDITIONAL INSURED - PRIMARY INSURANCE This endorsement modifies insurance provided under the following: COMMERCIAL LIABILITY COVERAGE FORM Section IV, Commercial General Liability Conditions, paragraph 4., Other Insurance, subparagraph a. Primary Insurance, is amended by the addition of the following: However, coverage under this policy afforded to an additional insured will apply as primary insurance where required by contract, and any other insurance issued to such additional insured shall apply as excess and noncontributory insurance. Autnorizea Kepresentative 74434 (10/99)