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Home My WebLink AboutARCHER WESTERN CONTRACTORS LLC - INSURANCE CERTIFICATEAC RO�O® CERTIFICATE OF LIABILITY INSURANCE GAT (sl s1201z O) 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 endomement(s). PRODUCER ADO Risk services Central, Inc. Chicago IL office CONTACT NAME: He. Ezt): (866) 283-7122 aC. No.: (847) 953-5390 EMAIL ADDRESS: 200 East Randolph Chicago IL 60601 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Arch insurance Company 11150 Archer western Contractors, LLC 2121 Avenue 3 INSURER B: Allied world National Assurance Company 10690 INSURER C: suite 103 Arlington TX 76006 USA INSURER D: INSURER E: INSURER F: F91604;T_TeTd 1114:11IIIJDF-AKarl JA=1 :4ANR1 191.r01a1y4: 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. Limits shown are as requested LTR TYPE OF INSURANCE INSR W ID POLICY NUMBER MMVDD= MMI00 LIMITS A GENERAL LIABILITY 41PKG8875006Ub/Ul/ZUIZ EACH OCCURRENCE $1,000,000 % COMMERCIAL GENERAL LIABILITY SIR applies per policy terns & condi ions MA PREMISES (Ea occurrence) $300, 000 CLAIMS-MADE X❑OCCUR MED EXP(Any one Person) $25,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000, 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $2,000,000 POLICY X PRO JECT LOC A AUTOMOBILE LIABILITY 41PKG8875006 ADS 06 Ol 2012 06 01 2013 COMBINED SINGLE LIMIT E,acoad,) $2,000,000 BODILY INJURY (Pet Wwn) A X ANY AUTO 41CA88875106 06/01/201206/01/2013 BODILY INJURY (Per accident) ALL OWNED SCHEDULED MA ONLY AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident B UMBRELLAIUA OCCUR 03056149 06/01/201206/01/2013 EACH OCCURRENCE $10,000,000 % EXCESS LIAR H CIAIIASMADE AGGREGATE $10,000,000 DED RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I M ANYPROPRIETOR I PARTNER I EXECUTIVEEACH 41WC18874906 06/01 2012 06/01 2013 WC STATU- OTH- X TORY LIMITS ER E.L. EAACCIDENT $1,000,000 OFFICERIMEMBER E%CLUDEOt O NIA ET. DISEASE -EA EMPLOYEE $1,000.000 (Mandatory In NH) H yes descdbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aracb ACORD 101, Admeonal Remarks Schedule, R space is required) RE: Water/Wastewater Treatment Design/COnStruCti On Contractor RFP #R20. See attached. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELnrERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins, Colorado AUTHORIZED REPRESENTATIVE 4316 LaPorte Avenue Fort Collins CO 80522 USA � rJi0ltr�tilJ �� m m to 0 do 0 n w O 2 m u W_ c m O ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (20'10105) The ACORD name and logo are registered marks of ACORD