HomeMy WebLinkAboutESS METRON PACKAGED PUMP SYSTEMS LLC - INSURANCE CERTIFICATEClient#: 35619
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ACORD,. CERTIFICATE OF LIABILITY INSURANCE
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1z/22/20z/zo11
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
(NAME:
IMA,Inc.- Colorado Division
I PHONE.No, 303-534-4567 IFAX 303-534-0600
N
(AIDEX,): (AC o
1550 17th Street, Suite 600
EMAIL
Denver, CO 80202
ADDRESS:
--
1NSURER(S AFFORDING COVERAGE
NAIL#
303-534-4567
INSURER A: Wausau Underwriters Ins. Co.
26042
INSURED
INSURER B: Federal Insurance Co (Chubb)
20281
Ferrier Franzmann Industries, LLC
I NSURER C: Great Northern Ins Co(Chubb) GNhICCh
20303
ESS Matron Packaged Pump Systems, LLC
1505 W Third Ave
INSURER D
Denver, CO 80223
INSURERS:
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 CONTRACTOR 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
MO
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMIDDIYYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERALLIABILITY
_ CLAIMS -MADE OCCUR
X Bl1PD Ded:10000
TBJZ91452868051
11/14/2011
10/01/2012
EACH OCCURRENCE
$1 00O 000
PREMISETo aoccourance
s3000OO
MED EXP (Any one person)
$10000
PERSONAL B ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GENT AGGREGATE
17 POLICY
LIMITAPPLIES PER:
X PRP 57 LOC
PRODUCTS-COMPIOP AGO
s2,000,000
$
C
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OSCHEDULED
AUUTOSS AUTOS
HIRED AUTOS X NON -OWNED
AUTOS
73571965
11/14/2011
10/01/2012 COMBINED SINGLE LIMIT
Ea apcitlent
BODILY INJURY (Par person)
BODILY INJURY (Per accident)
PROPERTY .rt) AGE
Per asulitlent
s
X
I S1,00g,ggg
S1,000,000
X
S
S
UMBRELLA LIAB
EXCESS LIAB
H OCCUR
CLAIMS -MADE
EACH OCCURRENCE
S
AGGREGATE
$
OEO RETENTIONS
S
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED? �
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS bolo%.
NIA
71739807
11/14/2011
10101/201
X T' STATU- OTH-
E.L EACHACCIDENT
$1 OOO OOO
E.L. DISEASE - EA EMPLOYEE
$1 OOO 000
E.L. DISEASE -POLICY LIMIT
$1,ODo'000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHID LES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
RE: RFP 7294 Irrigation Pump Station Maintenance & Repair.
The City of Fort Collins, its officers, agents and employees are included as Additional Insureds on the
General and Automobile Liability Policies if required by written contract or agreement subject to the
policy terms and conditions.
City of Fort Collins
Director of Purchasing and Risk Management
PO Box 580
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
ACORD 25 (2010/05) 1 of 1
#S774786/M774620
(cJ 1988-2010 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
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