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HomeMy WebLinkAbout109888 INSITUFORM TECHNOLOGIES INC - INSURANCE CERTIFICATE (11)ve. R CERTIFICATE OF LIABILITY INSURANCE L� 7/1/2013 DATE 011'YYY) 6/21/2012 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 INSURERS), 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 Lockton Companies,LLC-1 St. Louis Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 O CONTACT NAM A/c No, Eat): ac No E-MAIL ADDRESS INSURERS) AFFORDING COVERAGE NAIC a INSURERA: LiMnyMutualFir, insurenceCompany(M) 23035 INSURED nSI(Uform Technologies, I C. ] 041932 17988 Edison Avenue Chesterfield MO 63005 INSURER B : Liberty Insurance Corporation (64) 42404 INSURER C INSURER N COVERAGES INSTE02 2235TERTIFICATE NUMBER: 3731597 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 LM TYPE OF INSURANCE ADDL IN SUBR POLICY NUMBER EFF PM/ POLICY EXP LIMITS A GENERAL LIABILITY Y N TB2-641-004218-032 7/1/2012 7/1/2013 EACH OCCURRENCE s 2000000 A A X COMMERCIAL GENERAL LIABILITY 7 CLAIMS -MADE M OCCUR BROAD FORM PD/CONTRAC PER PROJECT AGG. CAP $20N UAL DAMAGE TO RENTED PREMISES a occurrence 350,000 MED EXP An one perwrR $ 10,000 PERSONAL S ADV INJURY s 2,000,000 X Independt Contractor X XCU GENERAL AGGREGATE $ 4,000,000 GENTAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4000000 POLICY X PRO LOC $ A AUTOMOBILE LIABILITY Y N AS2-641-004218-022 7/1/2012 7/1/2013 COMBINED SINGLE LIMIT Ea accident s 2,000,000 X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO AUTOWNED SCHEDULED BODILY INJURY (Per accident $ XXXXXXX HIRED AUTOS AUTOSSWNED Pere cRld ^DAMAGE $ XXXXXXX $ XXXXXXX UMBRELLA LIAR OCCUR EACH OCCURRENCE s XXXXXXX EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED I I RETENTION $ $ B B AND WORKERS COMP NSATIOIN ANY PROPRIETORPARTNERRSECUTIYE ❑ OFFICER/MEMBER EXCLUDED? N (Mandatory In NH) If yes, dexSe, uroer DESCRIPTION OF OPERATIONS be,- N/A N WA7-64D-009004442 WC7-641-004218-012(WI&O 7/1/2012 )7/1/2012 7/1/2013 7/1/2013 X IWRVUMIT OTH- E.L. EACH ACCIDENT $ 1 000000 E L. DISEASE- EA EMPLOYEE 1,000,000 EL DISEASE -POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, it more space is required) RE: P-763, CIPP SANITARY AND STORM SEWERS QRD YEAR OF TERM). THE CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSUREDS UNDER GENERAL LIABILITY AND AUTOM013ILL LIABILITY AS REQUIRED BY WRITTEN CONTRACT, BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE NAMED INSURED'S OPERATIONS. XX UMM I InL.A I M NULULK CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3731597 AUTHORIZED REPRESENTATIVE CITY OF FORT COLLINS 215 N. MASON STREET FORT COLLINS CO 80524 ACORD 25 (2010/05) ©1988- RD COIRTTORAiHON. All rights reserved the ACORD name and logo are registered marks of ACORD CERTIFICATE II CERTIFICATE OF LIABILITY INSURANCE �� 7/1/2013 DATE 6/21//21/2012 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 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 Lockton Companies,LLC-1 St. Louis Three Cityy Place Drive, Suite 900 St.Louis M063141-7081 (314) 432-0500 CONTACT M AIc No, Ea : FAX AIC, No) E-MAIL ADDRESS AFFORDING COVERAGE NAIC k INSURERA: LilertyMutual! Fire Insurance Companv(ba) 23035 INSURED In5Itu10rm Technologies, Inc. 1041932 17988 Edison Avenue Chesterfield MO 63005 INSURER B : Liberty Insurance Corporation (64) 42404 INSURER C INSURER F COVERAGES INSTF02 27i$rERTIFICATF NIIMRFR- ')f;C0S97 RFVI41r1N NI IMRFR- XXXXXYY 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 TR rypE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF M/DDfYYYY POLICY UP MMIDDrYYYY LIMITS A GENERAL LABILITY Y N T82-641-004218-032 7/1/2012 7/1/2013 EACH OCCURRENCE 2000000 A A X COMMERCIAL GENERAL LIABILITY C[AIMS-MADE ] OCCUR BROAD FORM PD/CONTRAC'UAL PER PROJECT AGG. CAP $20K DAMAGE TO RENTED PREMISES Eaoc,arm 350000 MED UP (My one pesord s 10,000 L 8 ADV INJURY s 2,000 000 X Indeoendt Contractor X XCU AGGREGATE $ 4 000 000 GENT AGGREGATE LIMIT APPLIES PER: S-COMP/OPAGG $ 4000000POLI Y X PE 0 LOG $A AUTOMOBILE LIABILITY Y N AS2-641-004218-022 7/1/2012 7/1/2013 MAGG SINGLE LIMIT s2000000ANY JURY (Per person) $ XXXXXXXAUTOS AUTO NED gtCITOSULED JURY (Per accitlent $XXXXXXXHIRED AUTOS NON -OWNED AUTOS DAMAGE nt $ XXXXXXX• $XXXXXXX UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS -MADE NOTAPPLICABLE AGGREGATE $ XXXXXXX LED I I RETENTION $ $ B B EMPLOWRKERS ERS'LABILIOry OFFFR ANYPROPRIETORPARTNER/EXECUTIVE N ICER/MEMBER EXCLUDED? N/A N WA7-64D-009004-442 WC7-641-004218-012 (WI &O 7/1/2012 )7/I/2012 7/1/2013 72013 X TOC STA U OTH- filAND E.L. EACH ACCIDENT s 1000000 E.L. DISEASE - EA EMPLOYEE 1 000000 (Mandator,es,deW If and DESCtle TICH OF DESCRIPTION OF OPERATIONS Lelnw E.L. DiSEASE'POLiC un, 1 000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I(Anach ACORD 101. Additional Remarks Schedule, if more space is required) RE: P-1022, CURED -IN -PLACE PIPE SANITARY AND STORM SEWERS. THE CITY OF FORT COLLILNS, ITS OFFICERS. AGENTS AND EMPLOYEES ARE ADDITIONAL INSUREDS UNDER GENERAL LIABILITY AND AUTOMOBILE LIABILITY AS REQUIRED BY WRITTEN CONTRACT, BUT ONLY WITH RESPECT TO LIABILI IY ARISING OUT OF THE NAMED INSURED'S OPERATIONS. XX nvLn�n t AINUCLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2660597 AUTHORIZED REPRESENTATIVE CITY OF FORT COLLINS 215 N. MASON STREET FORT COLLINS CO 80524 ACORD 25 (2010/05) ©198B- RD CO RA ON_ All rinhte recarved The ACORD name and logo are registered marks of ACORD