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HomeMy WebLinkAboutAET ENVIRONMENTAL INC - INSURANCE CERTIFICATEUP IU: Lb AIII CERTIFICATE OF LIABILITY INSURANCE °AT04/11/11 Y' 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). ' , i,., . PRODUCERNAME 303-744-1341 Henry Ham Agency, Inc. - - - P.O. Box 100547 303-744-0654 645 E. Evans Ave. .. Denver, CO 80250__-_ Hank Ham CONTACT pNONE FA% .. AIC No Ent : No): E-MAIL ADDRESS: PRODUCER SDUE001 CUSTOMER,,,: INSURER 5 AFFORDING COVERAGE . NAICa INSURED Source Environmental, Inc. DBA: AET Environmental, Inc 14.16 Lakeside Lane Denver, CO 80212 INSURER A:Chartls Risk Specialists - INSURER B:Travelers Insurance INSURER C: Pinnacol Assurance INSURER D:Ar onaut Insurance Company INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 TYPEOF INSURANCE AD UB POLICY NUMBER MM/DDPOLICYEFF rfYYY POLICY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY X CLAIMS-MADE1:1 OCCUR 18256315 ... 05101111 05101/12 - EACH OCCURRENCE $ 2,000,00 ff— PREMISES Ea occurrence S 300,00 MED EXP(Anyone person) - IS - 25,00 PERSONAL S ADV INJURY $ 2,000,00 X ,Professional Liab GENERAL AGGREGATE - $ 2,000,00 GEN'LAGGREGATE LIMIT APPLIES PER'. POLICY . PRO- LOC JECT PRODUCTS-COMP/OP AGG $ 2,000,00 $ ' A AUTOMOBILE LIABILITY- _ ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS - CA1932252 _ 05101/11 - 05101112 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY (Par accident) $ PROPERTY DAMAGE (Peraccidenl) $ $ $ A X UMBRELLA LIAB EXCESSIL OCCUR CLAIMS -MADE 18259214 05/01111 05101/12 EACH OCCURRENCE $ 8,000,00 AGGREGATE $ DEDUCTIBLE` I RETENTION $ 10,000 - $ X $ C D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) 11 yes, describe under DESCRIPTION OF OPERATIONS below NIA 3445583 47718828242 I 05/01111 05/01111 05101/12 05/01/12 X WCSTATU- OTH- R E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 EL DISEASE -POLICY LIMIT 1 $ 1,000,00 g Equipment Floater Deductible $1000 660.5906L866 01121110 01121111 Misc Tool 25,00 Rent Equi 50,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace Is required) r'FRTIFIr:ATF Hnl nFR CANCELLATION CITF002 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. P O Box 580 AUTHORIZED REPRESENTATIVE (1 I o Fort Collins, CO 80522 © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD