HomeMy WebLinkAboutUNION PACIFIC RAILROAD - INSURANCE CERTIFICATE212 345-5000 4/13/2012 3:43:53 PM PAGE 2/002 Fax Server
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,acorro CERTIFICATE OF LIABILITY INSURANCE
DATE(MM,DDIYYYY)
ON 13T2012
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
Marsh USA Inc.
2405 Grand Boulevard, d900
CONTACT
NAME:
NAME
FAX
NC No:
�Ald No Earl(NC.
EMAIL
ADDRESS:
Kansas City, MO 64108
INSURERS AFFORDING COVERAGE
NMCN
586630 RRPLIC2S2010
INSURER A : Hudson Insuralr'e Co
25054
INSURED
Union Pa ibc Railroad
INSURERS:
INSURER C
1400 Douglas Street
Omaha, NE 66179-1870
INSURER 0
INSURER E:
INSURER F
COVFRAr.FS CFRTIFICATF NIIMRFR- CHTftLLIafJlTI REVISION NUMBER-1
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
ADDLSUBR
POLICY NUMBER
POLICY EFF
MWDD/YYYY
POLICY EXP
MWDDM
UMrTS
A
GENERAL LIABILITY
HRRP0001-10
06912010
081012012
EACH OCCURRENCE
$ 2,000,000
PREMISES Ea {a]:LIIRICA
$
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE PE OCCUR
MID EXP(Any we po,son)
5
X Railroad ProL Ave
PERSONAL S ADV INJURY
$
GENERAL AGGREGATE
$ 6,000,000
GENL AGGREGATE
LIMIT APPLIES PER:
PRODUCTS-COMPIOPAGG
$
P0UCV
X PRO- LOC
$
AUTOMOBILE
LIABILITY
COMBINED SN L EUKITT
.oWdont
$
BODILY INJURY(Parolnsdn)
$
ANYAUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (par ocoderrt)
$
NON OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
er.cident
$
$
UMBRELLA LIAR
OCCl1R
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CWMS MADE
LED I I NETENmIXJ$
$
WORKERS COMPENSATION
WC STATU- LOTH
ANDEMPLOYERS' LIABILITY ,.INDRY
E.L. EACH ACCIDENT
$
ANY PROPRIUMPARTNERIEXECLmVE
OFFICEMMEWER EXCLUDED?
NIA
E.L. DISEASE - EA EMPLOYE
$
(Mandatory in NH)
II yas, d..Ns UMer
DESCRIPTION OF OPERATIONS trodw
E.LDISEASE-POLICYLIMIT
$
DESCRIPTION OF OPERATIONS ILOCATIONS I VEHICLES (ARach ACORD 101. AUUltlonal Remada Schedule, If more space Is required)
UP Ruder A 03696.36
Desffip'.Onof Prgece Rehm Listing conduibkaDe and ins -all new conduit and Cable(14 mnduid) in road row under m lmad Vessel.
Localmof PruecL Fon Cuiins,Colerado
Estimated Stan Date: Apnl 09,2012
Premium: $1,200.00 CKA425473
'COVERAGE PROVIDED FOR DURATION OF'WORK' WITHIN FIFTY FEET OF THE RAILROAD PROPERTY NOT TO EXCEED TWELVE MONTHS
Ciyof Fort Collire, CokXado
Ann: Rob Irish
P. 0. BOX 560
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
of Marsh USA Inc.
Keith A. Stiles
019RR_2n1n ACORn CORPORATION All rinhla roa P..,ed
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD