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HomeMy WebLinkAbout486984 LAYNE INLINER LLC - INSURANCE CERTIFICATEd►_ o� CERTIFICATE OF LIABILITY INSURANCE `5n/zo13 DATEIMMIDD/YYYY) 4/9/2012 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 pollcy(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 endomement(s). PRODUCER Lockton Companies, LLC-1 Kansas City 444 W. 47th Street, Suite 900 Kansas Cityy 64112-1906 (816) 960-9000 O,I C 0 w CONTACT A/C No Ext : A FAX No E-MAIL ADDRESS, COVERAGE NAICa INSURER A: Old Republic Insurance Com anv 24147 INSURED LAYNE INUNER, LLC 26 7915 CH ERRYWOOD LOOP KIOWA, CO 80117 INSURER B: INSURER C: INSURER F COVERAGES 1_AYIN01 FK CERTIFICATE NUMBER: 11412295 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLM lMMIDDrYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY DLAIMSlaADE EJ OCCUR X CONTRACTUAL Y N MWZY59151 5/1/2012 5/1/2013 EACH OCCURRENCE 2.000000 PREMI E TO ES .E NTErmnce 500,000 MED EXP (My one rson 10,000 PERSONAL a ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 5,000,000 GENT AGGREGATE X P LIMIT APPLIES PER: JET LOC PRODUCTS - COMP/OP AGG s 5,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALLOWNED AUTOSULED HIRED AUTOS X NON -OWNED N N MWT1321277 5/1/2012 5/1/2013 COMBINED SINGLE LIMIT $2000000 BODILY INJURY (Per person) $ XXXXXXX Ix BODILY INJURY (Per accident $ XXXXXXX PReOPERde DAMAGE $ 'XX'XXXXX $XXXXXXX UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE s XXXXXXX AGGREGATE s XXXXXXX DED I I RETENTION $ $ A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/FXECI,GrE OFFILEILMEMBER EXCLUDED? N tMyandalary In NH) descrude under DESCRIPTION OF OPERATIONS .1. NIA N MWC 11701600 STOPGAP(ND,OH,WA,WV,W 5/I/2012 5/1/2013 X WC STATU- OTH- V IMITSFR E.L. EACH ACCIDENT $5000000 EL DISEASE - EA EMPLOYEE S.000 OOO E.L. DISEASE -POLICY LIMIT It5000000 DESCRIPTION OF OPERAT NS I L CATIONS I VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: FT. COLLINS, C . 7106 P SANITARY SEWER STORMWATBR MAINS REHAB. CERTIFICATE I10LDER IS AN ADDITIONAL INSURED AS RESPECTS GENE JTY COVERAGE, ONLY AS REQUIRED BY CONTRACT, SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11412295 CITY OF FT. COLLINS PURCHASING DIVISION PO BOX 580 FT. COLLINS, CO 80522 ACORD 25 (2010105) ©T91r8-2010 ACCf EDCORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD