Loading...
HomeMy WebLinkAboutDRILLPRO SERVICES INC - INSURANCE CERTIFICATEA� "® CERTIFICATE OF LIABILITY INSURANCE 9/15/2011 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 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 CONTACT Jennifer Arnold NAME: Colorado BW Insurance Agency, Inc. 12000 North Washington PHCNEo n: (303)451-5547 C. No;(303)453-0605 ADDRESS: PRODUCERLIST 00240741 Suite 201 INSURERS AFFORDING COVERAGE NAICft Thornton CO 80241 INSURED INSURERA:State Auto Insurance Companies INSURERS National Union Fire Ins Cc of DrillPro Services, Inc. INSURER C:Pinnacol Assurance 141190 INSURERD:Cru1BP Insurance Services Inc 2220 74th Place Unit A INSURER E : 1 INSURER F: Thornton CO 80229 COVERAGES CERTIFICATE NUMBER:CL119227552 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 LTRI rypE Of INSURANCE ADDLISU R WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DDIVYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �}{ OCCUR X PBP2601606 1/1/2011 9/1/2012 EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ SOO, 000 MED EXP(Ad one person) $ 5,000 PERSONAL SADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X G I POLICY PR6 n LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OVvNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OVAED AUTOS X HAP2330294 9/1/2011 9/1/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00- X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ Uninsured motonst combined $ 1,000,000 Medical payments $ 5,000 BI X UMBRELLA LIAR EXCESS LIAB (OCCUR CLAIMS -MADE EE0160517200 9/1/2011 9/1/2012 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ DEDUCTIBLE RETENTION $ $ s C WORKERS COMPENSATION ANDEMPLOVER$'LIABILIW YIN ANY PROPRIETOR/PARTNERIEXECUTIVE ❑ OFFICER/MEMBER EXOLUDEDi (Mandatory in NH If yes, under D DESCRIPTIONIPTIONOF OPERATIONS belay AT 4 023119 9/1/2011 9/1/2012 X WC STATU- OTH- E.L. EACH ACCIDEM $ 100,000 E.L. DISEASE - EA EMPLOYE 8 100 000 EL. DISEASE - POLIGV LIMIT $ - 500 000 D I Pollution X I I7930002730000 9/1/2011 9/1/2012 $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is listed as Additional Insured as respects General Liability, Commercial Auto S Pollution Liability and their interest in operations of the named insured per written contract. City of Fort Collins Operations Services 117 N. Mason St Foit Collins, CO 80521 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 Arnold/JAT ACORD 25 (2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025 (2C09D9) The ACORD name and logo are registered marks of ACORD