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HomeMy WebLinkAbout389317 PROCTOR ENGINEERING GROUP LLC - INSURANCE CERTIFICATEA� oe CERTIFICATE OF LIABILITY INSURANCE 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 lieupof such endorsement(s). PRODUCER Santa Marla Company DI 1550 Parkside Drive Suite #200 Walnut Creek, CA 94596 R wWW.smcnsk.Com fT CONTACT NAME: Ced FICate Dep rim nt PHONE IAIC Np-Eall 925-956-76D0 FAX TAIL Nol:— EMAIL aooaass: rertiffirateataxifirricr'sk com INSURERSINSURERSI AFFORDING COVERAGE NAIL Y INSURER A: Valley EQroo Company INSURED Proctor Engineering Group, LLC 418 Mission Ave. San Rafael CA 94901 INSURER B Nsu RER c: NSURER O: INSURER E: _ INSURER F : COVERAGES ccaTIFIn ATENH1V1RFR- IRn.lnnnir REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POqTERMS, INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL _ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL5UBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES EaEwalErrence $ MED EXP(Any one person) $ CLAIMS -MADE OCCUR PERSONAL 5 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ $ POLICY Pp`'LOC AUTOMOBILE LIABILITY EOgBI NEDI SINGLE LIMIT $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS UTOS BNON-OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per aocidenl S 8 $ UMBRELLA LIAR OCCUR EACH OCCURRENCE E AGGREGATE g EXCESS LIAB CLAIMS MADE DED RETENTION $ S $ E A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN M:Y PROPRIETOR/PARTNEiLE%ELUTIVE �1 5085230146 7/1/2012 7/1/2013 WC STATU- 0 - TORYLIMITS E.L. EACY. ACCIDENT $ 1 DDD DDD OFFICERIMEMBER EXCLUDED' u (Mandatory In NH) NIA E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE -POLICY LIMIT 1 $ 1,000,000 If yes. describe under DESCRIPTION OF OPERATIONS belos A Workers Compensation- FL NV KS 5085230194 7/1/2012 7/1/2013 Statutory limits for FL, NV, KS DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (AHach ACORD 101, Additional Real Schedule, If more apace if NaNdred) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins ...Purchasingg Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 AUTHORIZED REPRESENTATIVE 'Fort Collins MO 80522 j�j�n C� A41, Carl A. Santa Maria ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD CERT NO.: 13848686 Heather De Piero 8/13/2012 3:30:40 PM Page 1 of 1