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Home My WebLink About330448 JACO ENVIRONMENTAL INC - INSURANCE CERTIFICATE (3)AI`OR�® CERTIFICATE OF LIABILITY INSURANCE page 1 of 1 09/1 /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 Willie of Seattle, Inc. c/o 26 Century Blvd. P. O. Box 305191 Nashville, TN 37230-5191 CONTACT NAM ' PHONE FAX AIDN EXT: 877-945-7378 N 888-467-2378 AbmDAES. Certificates@willis.com INSURER(S)AFFORDING COVERAGE NAICe INSURERA: Zurich American Insurance Company 16535-001 INSURED JACO Environmental, Inc. `0 `� S: INSURERSt. Paul Fire and Marine Insurance Compan 24767-001 INSURERC: Steadfast Insurance Company 26387-001 PO Box 14307 Mill Creek, WA 98082 INSURER D: INSURER E: NSURERF: COVERAGES CERTIFICATE NUMBER: 16527484 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 TR TY'PEOFINSURANCE ADVIL UWN SUBF WVD POLICYNUMBER POLICY EFF fMMDDIYYYY1 POLICY EXP (MWDD1YYYYILIMITS A GENERALLIABILITY GL0672515901 9/15/2011 9/15/2012 EACHOCCURRENCE $ 2,000,000 Pq EMIT SES Ea occurence $ 1 000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MED EXP(Any one person) $ 5,000 PE RSONAL B ADV I INJURY $ 1,000,000 X WA Stop Gap Included X $10,000 Deductible GENERALAGGREGATE $ 2,000,000 G EN'L AGE REGATE LI MIT APPL I ES PER. PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO- JECTLOD $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccidem $ BODILY NJURY(Per person) $ ANYAUTO AU OS SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident ) $ HIREDAUTOS NON -OWNED AUTOS A Peraccidenl $ B X UMBRELLA LIAB X OCCUR OK09401356 9/15/2011 9/15/2012 EACHOCCURRENCE $ 5,000,000 AGGREGATE $ 51000,000 EXCESS LIAB CLAIMS -MADE DED (RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERTLIABILITY YIN ANY PROPRIETOR/PAR.TNER/EX.ECUTIVE � OFFICER/MEMBER EXCLUDED? fIMandatory in NH) Yes, of acniae under N/A WC672515801 9/15/2011 9/15/2012 X E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L.DISEASE - POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS below C CPL672516201 9/15/2011 9/15/2012 Pollution Legal Liability $5,000,000 Per Incident including BI/PD & Cleanup $5,000,000 Aggregate $ 25,000 Deductible Each Incident DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach Acord 101, Additional Remarks Schedule, if more space is required) The Workers' Compensation policy covers California, New Mexico, Nevada, Oregon, Utah, Illinois, Colorado, Idaho, Georgia, Maine, Maryland, Massachusetts, Michigan, New Jersey, Pennsylvania, Arizona, New York, Texas and Maine only. The Umbrella policy also extends over the primary auto liability policy which has a $2,000,000 limit. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Purchasing Division AUTHORIZED REPRESENTATIVE Attn: Christine Patterson -Jarvis 700 Wood Street Fort Collins, CO 80522-0580 v-`— F Gay Coll:3485062 Tp1:1323371 Cert:16527484 01988-2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 09/`1 /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 Willie of Seattle, Inc. c/o 26 Century Blvd. NAM PHONE FAX XT: 877-945-7378 INC N 888-467-2378 P. O. Box 305191 Nashville, 37230-5191 E-MAIL EDDR CertificateBOwillis.com INSURERfS)AFFORDING COVERAGE NAIC4 INSURER A: Zurich American Insurance Company 16535-001 INSURED JACO Environmental, Inc. INSURERS steadfast Insurance Company 26387-001 INSURERC PO Box 14307 Mill Creek, WA 98082 INSURER D. NSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 16527336 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 TYPEOFINSURANCE DD' SUB POLICY NUMBER POLICY EFF POLICY EXP-LTJL an LIMITS A GENERAL LIABILITY y GLO672515901 9/15/2011 9/15/2012 EACHOCCURRENCE S 2,000,000 RAMAGETO RENTED PREMISES Ee occurence S 1,00G,000 X I COMMERCIAL GENERAL LIABILITY VIED EXP(Any one person) 3 5,000 CLAIMS-MADEFX�OCCUR PERSONAL&ADV INJURY $ 1 OOO 000 X WA Stop Gap Included X 510, 000 Deductible GENERAL AGGREGATE $ 2,000,000 GENIAGGREGATE LIMITAPPLIESPER: PRODUCTS - COMP/OP AGG $ 2,000.000 POLICY X PRO- LOC AUTOMOBILE LIABILITY MBINED SINGLE LIMIT (Ea accitlenl S BODILY INJURV(Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURV(Per accident) ) $ HIREDAUTOS NON -OWNED AUTOS AMAGE Per accitlenl $ S UMBRELLA LIAB OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAB CLAIMS -MADE DED I IRETENTION$ Is WORKERS COMPENSATION ANDEMPLOYERTLIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICEWMEMBER EXCLUDED? N/A W H- T RV M E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ Mandatory in NH) f yes, describe under E.L. DISEASE -POLICY LIMIT IS DESCRIPTION OF OPERATIONS below B CPL672516201 9/15/2011 9/15/2012 Pollution Legal Liability $5,000,000 Per Incident including BI/PD & Cleanup $5,000,000 Aggregate $ 25,000 Deductible Each Incident DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHech Acord 101, Addifonal Remarks Schedule, if more space is required) See Attached. Professional E E O Carrier: Executive Risk Indemunity Inc. City of Fort Collins Attn: Opal Dick 700 Wood St. 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 W20M Coll: AGUHU 20 (ZUl U Ub) 85062 Tpl:1323388 Cert:16527336 01988-2010 The ACOHD name and logo are registered marks of ACORD reserved AGENCY CUSTOMER ID: LOC#: ACOR" ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED JACO Environmental, Inc. Willis of Seattle, Inc. PO Box 14307 Mill Creek, WA 98082 POLICY NUMBER See First Page CARRIER IC CODE See First Page EFFECTIVEDATE: See First Page ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, rnmumiumpo. 25 cnoMl TIT]G• CERTIFICATE OF LIABILITY INSURANCE umneI: biYYbb`JU IS Date: 09/15/2011 on Date: 09/15/2012 R,000,000 Each Claim ,000000 Aggregate $ 15,, 000 Retention, Each Claim It is agreed that City of Fort Collins and its officers, agents and employees are included as Additional Insureds as respects to General Liability where required by written contract. ACORn tnt l9nnR/nii rnll-14RSn69 Tnl n0nn2Arn0nrnConoA7lnM Au.I,.u�...�,•.•,,.d The ACORD name and logo are registered marks of ACORD