HomeMy WebLinkAbout450906 MULLER ENGINEERING CO INC - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE OP ID XL DATE(MWDD/YYYY)
09 15 11
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: the certificate holder is an ADDITIONAL INSURED, the polic ifs 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
ACEC/MARSH
701 Market St., Ste. 1100
St. Louis MO 63101
Phone:800-338-1391 Fax:888-621-3173
NAME:
01Ext: (AIC, No):
ADDRESS:
PRODUCE
CUSTOMER ID e: M3LLE-1
INSURER(S) AFFORDING COVERAGE
NAICM
INSURED
Muller Engineering Co., Ina•
777 S.Wadoworth Blvd., Ste 100
Lakewood CO 80226
INSURER A: Hartford Accident A Indawnity
INSURER B:
INSURER C:
INSURER D :
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
TYPE OF INSURANCE
INSR
WVD
POLICY NUMBER
(IAM/ODNYYY)
(MWDDIYYYY)
LIMBS
GENERAL LIABILITY
EACH OCCURRENCE
$2,000,000
PREMISES (Ea o nrenca
$2,000,000
A
X COMMERCIAL GENERAL LIABILITY
84SBWCT1553
11/01/11
11/01/12
MED EXP (My one person)
$10,000
CLAIMS -MADE ❑X OCCUR
PERSONAL S ADV IWURY
$2,000,000
X XCU
GENERAL AGGREGATE
s4,000,000
eaoraeaxoNAc cxAa excl.
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$4,000,000
$
17 POLICY X JECOT 7 LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
52,000,000
A
ANY AUTO
84UEGNS8431
11/01/11
11/01/12
X
BODILY INJURY (Per person)
$
BODILY IWURY(Per accident)
$
ALL OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
SCHEDULED AUTOS
HIREDAUTOS
X
NON -OWNED AUTOS
X
S
$
A
UMBRELLALIAB
g
OCWR
84SBWCT1553
11/01/11
11/01/12
EACH OCCURRENCE
$1,000,000
EXCESS LU1B
CUIMS-MADE
AGGREGATE
$ 1, 000, 000
DEDUCTIBLE ---
$
----
-
$
RETENTION $
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNEWEXECUTIVFDI
OFFICER/MEMBER EXCLUDEDT u
(Mandatory In NH)
/A
84WEGPM013
11/01/11
11/01/12
X I TORYLIA _ER
E.L. EACH ACCIDENT
$1, 000, 000
E.L. DISEASE - EA EMPLOYE E
$ 1, 0 00 , 0 0 0
E.L. DISEASE - POLICY LIMIT
$1, 000, 000
Ifyes, tlascribe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ANach ACORD 101, Additional Remarks Schedule, H more space is required)
RE: P1147 SIGNAL TIMING PROGRAM. THE CITY, ITS OFFICERS AND EMPLOYEES IN
ACCORDANCE WITH C04OPADO LAW ARE INCLUDED AS ADDITIONAL INSURED FOR ABOVE
COVERAGES EXCEPT W/C.
rcorrvr Arc uni nco CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CTYFTCO I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
CITY OF FT. COLLINS
ATTN: JAMES B. OINEILL
PO BOX 580
All rights
ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD