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Home My WebLink About330448 JACO ENVIRONMENTAL INC - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 09/(18/2012 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 Willie of Seattle, Inc. c/o 26 Century Blvd. CONTACT NAME' PHONE FAX ('VC N EXT: 877-945-7378 N ' 888-467-2378 P. O. Box 305191 Nashville, TN 37230-5191 ADDRES: Certificates@willis.com INSURER(S)AFFORDING COVERAGE NAICN aA 0 W A INSURERA: Aspen Specialty Insurance Company 10717-001 INSURED TACO Bnvitonmentnl, Inc. INSURER B: INSURERA PO Box 14307 Kill Creek, WA 98082 INSURER D: INSURER E: INSURER F� COVERAGES CERTIFICATE NUMBER: 18547995 REVISION NUMBER: 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 TYPEOFINSURANCE DD' SUB POLICY NUMBER POLICY EFF POLICY EXP-LIEL LIMITS A GENERAL LIABILITY y EEAAX1412 9/15/2012 9/15/2013 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Me occurence $ 11000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MEDEXP(Anyoneperson) $ 5,000 PERSONAL B ADV INJURY $ 2,000,000 X WA Stop Gap Included X $10,000 Deductible GENERALAGGREGATE $ 2,000,000 G ENL AGGREGATE LIMIT APPLIES PE R: PRODUCTS COMP/OPAGG $ 2,000,000 17 POLICY X PRO LOC g AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Eaaccideni $ BODILY INJURY(Per person) $ ANY AUTO OSCHEDULED AU AUTOSS AU TOS H BODILY INJURY P (or accident) S HIRED AUTOS NON -OWNED AUTOS PROPERTYDAMAGE Pereccdenl $ IS �1 HUMBRELLA LIAR OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE OED I IRETENTION $ $ WORKERS COMPENSATION - ANDEMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? N/A E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ fMandetdryin NH) i yes, tlescribe under E.L. DISEASE -POLICY LIMIT Is DESCRIPTION OF OPERATIONS below A ENAAK1412 9/15/2012 9/15/2013 Pollution Legal Liability $5,000,000 Per Incident including BI/PD E Cleanup $5,000,000 Aggregate $ 25,000 Deductible Each Incident DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more apace is required) See Attached: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins I AUTHORIZED REPRESENTATIVE Attn: Opal Dick 700 Wood St. Fort Collins, CO 80522 CO11:3861613 Tpl:1516487 Cert:18547995 01988-2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOCK: ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Willis of Seattle, Inc. POLICY NUMBER See First Page CARRIER NAIC CODE r. ADDITIONAL NAMED INSURED JACO Environmental, Inc. PO Box 14307 Mill Creek, WA 98082 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE - - Professional E & O Carrier: National Union Fire Ins. Co. of Pittsburgh Policy Number: 012377128 Effective Date: 09/15/2012 Expiration Date: 09/15/2013 Limits: $1,000,000 Each Claim $1,000, 000 Aggregate $ 15,000 Retention, Each Claim It is agreed that City of Fort Collins and its officers, agents and employees are included as Additional Insureds as respects to General Liability where required by written contract. 101(2008/01) C011:3861613 Tn1:1516487 Cert:18547995 02008ACORDCORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD