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HomeMy WebLinkAbout162366 CARL WALKER INC - INSURANCE CERTIFICATE (5)CERTIFICATE OF LIABILITY INSURANCE 12/19/20 1) 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 endorsements . PRODUCER Professional Concepts Insurance Agency, Inc. 1127 South Old US Highway 23 Brighton MI 48114-9861 CONTACT NAME: PHONE (800) 969-4041 FAX (000)969-4e81 E-MAIL . certsopciaonline.com INSURERS AFFORDING COVERAGE NAIC N INSURER A:Travelers Indenuaity Company INSURED CARL WALKER, INC 5136 LOVERS LANE SUITE 200 KALAMAZOO MI 49002 INSURER BHartford Underwriters Ins. Co. 30104 INSURERC%L Specialty Ins. Co. 37885 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:11/12 All 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 5UBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP IY MMIDDYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ilia o.cu,,encel $ 1,000,000 X COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE OCCUR 68CIB986710 2/31/2011 2/31/2012 MED EXP (Any one person) $ 10,000 PERSONAL B ADV INJURY $ 11000,000 X X,C,II ACP2B011953 TX 2/31/2011 2/31/2012 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 - GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ X POLICY X PRO LOC - AUTOMOBILE LIABILITY - MSINGLE LIMIT COEa accBINED ident 2,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS - A28014181 2/31/2011 2/31/2012 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X X NON -OWNED HIRED AUTOS AUTOS PIP -Basic $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 51000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DEO I X I RETENTION$ 10,00 $ UP002B013043 2/31/2011 2/31/2012 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED' (Mandmorym NH) NIA SNBCPN3ti45 2/31/2011 2/31/2012 A.I WC STAT% OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 R yyes, describe under DESCRIPDON OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 C Professional Liability PR9689186 0/15/2011 0/15/2012 per asm $ 2,000,000 Aggregate $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space is required) Project #: R320077037. City of Fort Collins is named as Additional Insured as respects to General Liability only and would apply to the above named project so long s required within a written contract. City of Fort Collins Second Floor 215 North Mason Street PO Box 580 Fort Collins, CO 80522-0580 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 Cosgrove/JL , [ ,M,-Z ACORD 25 (2010/05) INQA14 o nne,m Tr.- nnnon ___,- .-.-,a :............-....:.. b... I ---I- I nrnnn reserved. . 1.i CERTIFICATE OF LIABILITY INSURANCE `/ DATE (MMIDD011 12/19/2011 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 endorsements . PRODUCER Professional Concepts Insurance Agency, Inc. 1127 South Old US Highway 23 Brighton MI 48114-9861 CONTACT NAME: PHONE (800)969-4041 FAX1 Not (800)969-40a1 E'ME . certs®pciaonline.com INSURERS AFFORDING COVERAGE NAIC IN INSURER A:Travelers Indem:nity Company INSURED 1L CARL WALKER, INC 1I��j/1] ° 5136 LOVERS LANE SUITE 200 KALAMAZOO MI 49002 INSURER B Hartford Underwriters Ins. Co. 30104 INSURERC:XL Specialty Ins. Co. 37885 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:11/12 All 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 POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM DO LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 6801B986710 2/31/2011 2/31/2012 PREMISES Eaoccurrence) $ 11000,000 MED EXP(My oneperson) $ 10,000 PERSONAL &ADV INJURY $ 11000,000 IX x'c'u ACP28011953 TX 2/31/2011 2/31/2012 X Contractual Liability GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 $ X POLICY X PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 11000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS A2B014181 2/31/2011 2/31/2012 BODILY INJURY (Per accident) $ tDAMAGE $ X HIRED AUTOS X NON-OWNEDPROPERTY AUTOS PIP -Basic $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 51000,000 AGGREGATE It 5,000,000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 10,000 It 2UP002BO13043 12/31/2011 2/31/2012 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? (MandatoryM NH) N/A 5WEGPN3645 2/31/2011 2/31/2012 X I TWO STATU- OTH- DRY LIMITS ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below EL.DISEASE - POLICY LIMIT $ 1 000,000 C Professional Liability PR9689186 0/15/2011 0/15/2012 per Claim $ 2,000,000 Aggregate $ 2,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Project #: R32006017. City of Fort Collins is named as Additional Insured as respects to General Liability only and would apply to the above named project so long as required within a written contract. City of Fort Collins Attn: Second Floor 215 North Mason Street P. O. Box 580 Fort Collins, CO 80522-0580 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 Cosgrove/JL �' "��u� a'�-�� ACORD 25 (201 ©1988-2010 ACORD CORPORATION. All rights reserved. WCMR mm�nn m rr,- A rnon ___- ..... ........a.....w . 11,- s Arnon