HomeMy WebLinkAbout155264 TREMCO ROOFING WEATHERPROOFING TECHNOLOGIES - INSURANCE CERTIFICATE (5)A� D® CERTIFICATE OF LIABILITY INSURANCE
DATE
o2011 rrv>
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 puc icy(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 endorsement(s).
PRODUCER
MARSH USA INC.
200 PUBLIC SQUARE, SUITE 1000
CLEVELAND, OR 44114-1824
CONTACT
NAME:
PHONE I FA%
ac No:
E-MAIL
ADDRESS:
PRODUCER
34492 -00000-CAS1 0-11-12 WEATH
INSURERS AFFORDING COVERAGE
NAIL N
INSURED
INSURER A: First Continental Services Co.
WEATHERPROOFING TECHNOLOGIES, INC.
TREMCO INCORPORATED AND ITS SUBSIDIARIES
INSURER B; Zurich American Insurance Company
16535
INSURER C : NIA
N/A
3735 GREEN RD.
BEACHWOOD, OH 44122
INSURER DCompany American Zurich Insurance Com n
:
40142
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER- CLE-002625147.17N RFVICInN 1U IMRi 1
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
LTfl
J TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
MM/DD/YYYY)
POLICY EXP
(MWDD/YYYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,1700
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE M OCCUR
1-GLRPM-0ll2011
0410112011
04/0112012
DAMAG T R NT D
PREMISES Ea occurrence)$
1,000,000
MED EXP (Any one person)
$ 5,000
PERSONAL B ADV INJURY
S 2,000,000
GENERAL AGGREGATE
§ 1,000,000
GENT AGGREGATE
LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
S 1,000,000
X PODCY
PRO- LOC
$
B
AUTOMOBILE
LIABILITY
ANY AUTO
BAP9258789-04
0410112011
041WI2012
COMBINED SINGLE LIMIT
(Ea accident)
$ 2000000
X
BODILY INJURY (Par person)
S
ALL OWNED AUTOS
BODILY INJURY (Par accident)
$
SCHEDULED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
HIRED AUTOS
X
NON -OWNED AUTOS
§
S
UMBRELLA LIAB
HOCCUR
EACH OCCURRENCE
$
AGGREGATE
$
CLAIMS -MADE
fEXESSIAB
LEN
$
S
D
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE Y / N
OFFICER/MEMRER EXCLUDED? F_N_1
N/A
WC92587B8-04(ADS)
WC9258790-04 (Wp
04/0112011
0410112011
04101/2012
0410112012
X I WC STATu- OTH
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE EA EMPLOYE
$ 1,000,WO
(Mandatory in Ni
It yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more apace is required)
City of Fort Collins is named as an additional insured during the course of authorized roof inspection and repair activities to the extent of losses caused solely and directly by Tremco andlor Weatherproofing Technologies,
Inc. employees in an amount not to exceed the cost of the contracted services.
CITY OF FORT COLLINS
215 NORTH MASON STREET, 2ND FLOOR
FORT COLLINS, CO 80522
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
of Marsh USA Inc.
Kevin J. Robinson %NwL JL. A&rCH
01988-2009 ACORD CORPORATION. All riahts
ACOHO 25 (2009/09) The ACORD name and logo are registered marks of ACORD
ADDITIONAL INFORMATION CLE-002825347-04 oDATE( MfDDNY)
PRODUCER
MARSH USA INC.
200 PUBLIC SQUARE, SUITE 1000
CLEVELAND, OH 44114.1824
34492-OOOOMAS10-11-12 WEATH
INSURED
WEATHERPROOFING TECHNOLOGIES, INC.
TREMCO INCORPORATED AND ITS SUBSIDIARIES
3735 GREEN RD.
BEACHWOOD, ON 44122
I EX
INSURERS AFFORDING COVERAGE
INSURER G:
INSURER H:
INSURERI:
INSURER J:
NAIC #
THE GENERAL LIABILITY AND AUTOMOBILE PHYSICAL DAMAGE PLACEMENT IS A DIRECT PLACEMENT. MARSH MANAGEMENT SERVICES (VERMONT) MANAGES THE CAPTIVE INSURER INDICATED
HERE. MARSH USA INC. HAS ONLY ACTED IN THE ROLE OF A CONSULTANT TO THE CLIENT WITH RESPECT TO THIS PLACEMENT, WHICH IS INDICATED HERE FOR YOUR CONVENIENCE.
CERTIFICATE HOLDER
CITY OF FORT COLLINS
215 NORTH MASON STREET, 2ND FLOOR
FORT COLLINS, CO 80522
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Kevin J. Robinson
Pa9?v a-(-r+-w r �llNt i�r :l• IP'i3 s�.3WN.QiI-ir y-1
4.. x.'n,w._._....v.,...rSt..c�✓s.�.,. ...asli,.:. ,va.,....,..._..,..c., �e�..v �`,�1.+ter.
'`� bP CERTIFICATE OF LIABILITY INSURANCE
-DATE912011 vvv)
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 endorsement(s).
PRODUCER
MARSH USA INC.
200 PUBLIC SQUARE, SUITE 1000
CLEVELAND, OH 44114-1824
CONTACT
NAME:
PHONE FA%
ac No:
EMAIL
ADDRESS:
U
CUSTOMER
34492-00000-CAS10-11-12 WEATH
INSURER(S) AFFORDING COVERAGE
NAIL 0
INSURED
INSURER A: First Continental Services CO.
WEATHERPROOFING TECHNOLOGIES, INC.
TREMCO INCORPORATED AND ITS SUBSIDIARIES
INSURER B : N/A
N/A
INSURER C : N/A
N/A
3735 GREEN ROAD
BEACHWOOD, OH 44122
INSURER D :NIA
NIA
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER: CLEM262534610 RFVIBIr1N tJHMRFR- 0
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
I TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
MWDO/YYYYI
POLICY EXP
(MWDDNYYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,005
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE M OCCUR
1-GLRPM-01/2011
04/01I2011
04/0112012
PAMAGETURTII
REMISES Ea occurrence)
$ 1,000,000
VIED EXP (My one person)
$ 5,000
PERSONAL d ADV INJURY
$ 2�000,()DB
GENERAL AGGREGATE
S 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGO
S 1,000,000
RO- LOG
X POLICY P'FIT F
$
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY (Per person)
$
ALL OWNED AUTOS
BODILY INJURY (Per accident)$
SCHEDULED AUTOS
PROPERTY DAMAGE
(Per accident)
$
HIRED AUTOS
$
NON -OWNED AUTOS
S
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
IS
-
EXCESS LIAR
CLAIMS -MADE
DEDUCTIBLE
$
$
RETENTION $
WORKERS COMPENSATION
WGSTATU- OTH-
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNEWEXECUTIVE
OFFICER/MEMBER EXCLUDED?
WA
I
E.L. EACH ACCIDENT
$
E.L. DISEASE- EA EMPLOYE
$
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is rec ired)
CITY OF FORT COLLINS
215 NORTH MASON STREET, 2ND FLOOR
FORT COLLINS, CO 80522
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
of Marsh USA Inc.
Kevin J. Robinson WAA,��ft �J.- A4f,6�
1988-2009 ACORD CORPORATION. All riahts reserved.
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD
ADDITIONAL INFORMATION CLE-00262534610 DATE( MJDDm) /2011 I
PRODUCER
MARSH USA INC.
200 PUBLIC SQUARE, SUITE 1000
CLEVELAND, OH 44114-1824
34492-00000-CAS10-11-12 WEATH
INSURED
WEATHERPROOFING TECHNOLOGIES, INC.
TREMCO INCORPORATED AND ITS SUBSIDIARIES
3735 GREEN ROAD
BEACHWOOD, OH 44122
INSURERS AFFORDING COVERAGE
INSURER G:
INSURER H:
INSURER I',
INSURER J:
NAIC #
THE GENERAL LIABIUTY AND AUTOMOBILE PHYSICAL DAMAGE PLACEMENT IS A DIRECT PLACEMENT, MARSH MANAGEMENT SERVICES (VERMONT) MANAGES THE CAPTIVE INSURER INDICATED
HERE. MARSH USA INC. HAS ONLY ACTED IN THE ROLE OF A CONSULTANT TO THE CLIENT WITH RESPECT TO THIS PLACEMENT, WHICH IS INDICATED HERE FOR YOUR CONVENIENCE.
CERTIFICATE HOLDER
CITY OF FORT COLONS
215 NORTH MASON STREET, 2ND FLOOR
FORT COLLINS, CO 80522 -
AMORNED REPRESENTATIVE
of Marsh USA Inc.
Kevin J. Robinson
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