HomeMy WebLinkAbout384515 WILDCAT CIVIL SERVICES INC - INSURANCE CERTIFICATE (2)ACORO®
`� CERTIFICATE OF LIABILITY INSURANCE 1i1i2012
DATE (MM/DD/YYYY)
12/8/2010
PRODUCER Lockton Companies, LLC-1 Kansas City
#44 W. 47th Street, Suite 900
Kansas City MO 64112-1906
(816) 960-9000
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED WILDCAT CIVIL SERVICES
1312696 ATTN: TIMOTHY L. CARROLL
7915 CHERRYWOOD LOOP
KIOWA CO 80117
INSURER A: Hartford Fire Insurance Company
19682
INSURER B : Twin City Fire Insurance Company
29459
INSURER C : Hartford Insurance Co of the Midwest
37478
INSURER D :
INSURER E :
COVERAGES SHECOO 1 SA THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING
HIS
AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER.
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
ADD'L
-
POLICY EFFECTIVE
POLICY EXPIRATION
LTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE (MM/DD/YY)
DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
A
X COMMERCIAL GENERAL LIABILITY
37CSE U1081
Q
1/1/2011
1/1/2012
DAMAGE TO RENTED
PREMISES Ea occurence
$ 300 000
CLAIMS MADE FKOCCUR
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 21000,000
GENERAL AGGREGATE
$ 4,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 41000,000
POLICY X JECT PRO-
LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
37UENQUI082
1/l/2011
1/1/2012
COMBINED SINGLE LIMIT
(Ea accident)
$ 2000000
> >
X
BODILY INJURY
(Per person)
$ XXXXXXX
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$ XXXXXXX
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
ANY AUTO
NOT APPLICABLE
OTHER THAN EA ACC
$ XXXXXXX
AUTO ONLY: AGG
$ XXXXXXX
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$ XXXXXXX
OCCUR ❑ CLAIMS MADE
AGGREGATE
$ XXXXXXX
UMBRELLA
NOT APPLICABLE
$ XXXXXXX
$ XXXXXXX
DEDUCTIBLE FORM
$ XXXXXXX
RETENTION $
B
C
WORKERS COMPENSATION AND
LIABILITY y / ry
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) .
37WNQU1080
37WN UI083
Q
1/1/2011
I/l/2011
1/1/2012
I/l/2012
X I WC STATU-
TORY LIMITSER
TORY
E. L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: 7106 CURED -IN -PLACE PIPE SANITARY SEWER STORMWATER MAINS REHABILITATION. THE CITY, ITS OFFICERS, AGENTS AND
EMPLOYEES ARE NAMED AS ADDITIONAL INSURED ON GENERAL AND AUTOMOBILE LIABILITY AS PER WRITTEN CONTRACT.
10900651
CITY OF FORT COLLINS
FINANCIAL SERVICES
PURCHASING DIVISION
215 NORTH MASON STREET
2ND FLOOR, PO BOX 580
FORT COLLINS CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL WXi i(1 }qX MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
AUTHORIZED
ACORD 25 (2009/01)
988-2009 4ICCFD CORPORATION. All rights reserved
The ACORD name and logo are registered marks Of ACORD
For questions reaardinq this certificate, contact the number listed in the 'Producer' section above and soecifv the client code'SHECO01'.