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HomeMy WebLinkAbout486984 REYNOLDS INLINER LLC - INSURANCE CERTIFICATE (2)hI CERTIFICATE OF LIABILITY INSURANCE �� snnolz DATE 9/2/2 11 YYYI 9/2/2011 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 PRODUCERAND THE CERTIFICATE HOLDER. - IMPORTANT: If,the certificate holder is in 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 tlie- - - -- certificate holder in lieu of such endomement(s).- PRODUCER Lockton Companies, LLC-1 Kansas City _ 444 W, 47th Street, Suite 900_ Kansas -City MO 64112-1906 . (816)960-9000 r 1 VVl ZT- NAME:- INC, No Eat): INC, No :__ E-MAI;. A DRL INSURERS) AFFORDING COVERAGE NAIC # INSURER A: Old Republic Insurance COm anV 24147 INSURED REYNOLDS INLINER, LLC 26 7915 CHERRYWOOD LOOP KIOWA, CO 80117 INSURER e: INSURER C: N R R0: NELIRER INSURER F COVERAGES LAYIN01 FK CERTIFICATE NUMBER: 11412295 REVISION NUMBER: XXXXXXX 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 INSR SUBR W ID POLICY NUMBER POLICY EFF MMIDD POLICY EXP IV MM/DDYYY LIMITS A GENERAL LIABILITY Y Ni MWZY59151 5/1/2011 5/1/2012 EACH OCCURRENCE 2000,000 PRAEMISESOEsENTiErtence 500,000 X COMMERCIAL GENERAL LIABILITY MED EXP (Any oneperson) 10.000 CLAIMS -MADE EDOCCUR PERSONAL BADVINJURY $ 2,000,000 X CONTRACTUAL ..-.... , .,.. ... GENERAL AGGREGATE .. s 5,000,000 ... _ ._ GEN'L AGGREGATE LIT APPLIES PER' MI ...._. _.. ...... ._PRODUCTS-COMP/OP AGG$-S000.000 ..... ... :. _.7X v ' Po , PRO-.. _ ,. ...._.. IS A AUTOMOBILE LIABILITY ` .., .t, N 'N. MWTB 21277 5/I/2011 5/I/2012, COMBINED SINGLE LIMIT HIS, accident $2000000 X BODILYINJURY(Perperson) _ . $ XXXXXXX ANY AUTO - .. BODILY INJURY (Per accident $ XXXXXXX " '..,.� ALL WNED�-- AUTOS SCHEDULED..: AUTOS .._ X PROPERTY eOac idYtDAMAGE $ XXXXXXX HIRED AUTOS X AUTOS '- $XXXXXXX UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED I I RETENTION $ $ A '4 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORPARTNERIEDECUTI/E OFFICERIMEMSSR CMCLUDEDt N IMandalory in AN) N/A N MWC 11701600 STOPGAP(ND,OH,WA,WV,W 5/I/201I 5/1/2012 WC STATU- OTH- X TORY LIMITS FR EL EACH ACCIDENT $ 5000,000 EL DISEASE - EA EMPLOYEE 5,000,00!t0 DESCRIPTION OF OPERATIONS WM EL DISEASE -POLICY LIMIT 5.00o.06'O DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: FT. COLLINS, CO. 7106 CIP SANITARY SEWER STORMWATER MAINS REHAB. CERTIFICATE HOLDER IS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY COVERAGE, ONLY AS REQUIRED BY CONTRACT, SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11412295 CITY OF FT. COLLINS PURCHASING DIVISION PO BOX 580 FT. COLLINS, CO 80522 ACORD 25 t2010/051 ©T968-2010 ACCRD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD