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Home My WebLink About193076 RISK REMOVAL - INSURANCE CERTIFICATE (2)Av h® CERTIFICATE OF LIABILITY INSURANCE"NSUR° D10/12/2012 Y' 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 NAoMEncr KAREN OCONNELL AICNNo EMY 708-598-5355 ac No: 708-598-6686 BONDING &INSURANCE SPECIALISTS AGENCY, INC. 9340 S. HARLEM AVENUE gDORESS: KCCONNELL BISA-INC.COM INSURER(S) AFFORDING COVERAGE NAICN BRIDGEVIEW, IL 60455 IN CALIFORNIA, DBA BONDS AND INSURANCE SERVICES, LIC. 110796,11119 INSURER A: ARCH SPECIALTY INSURANCE COMPANY 21199 INSURED 1 %U� INSURER B'. INSURER C: MORROW HOLDINGS, LLC D/B/A RISK RE_ MOVAL INSURER D: 1925 TIMBERLINE ROAD, OFFICE 1 INSURER E: FORT COLLINS, CO 80525 INSURER F' COVERAGES CERTIFICATE NUMBER: 119089 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF MMIDDNYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY Y Y EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE �X OCCUR 12EMP7196501 10/01/12 10/01/13 PREMISES(Ea ence) $ 50,000 MED EXP (Any one person) $ 5000 X ' CONTRACTORS POLLUTION FW PERSONAL & ADV INJURY $ 1,000,000 X INCLUDES ASBESTOSBLEAD GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIESPER'. PRODUCTS AGO $ 2000000 POLICv X PE° LGC PER CLAIM $ 1,000,000 AUTOMOBILE LIABILITY COMBINED O BINEnl) INGL IMI $ BODILY INJURY (Per Person) $ ANY AUTO ALL OWNED AUTOS AUTOS BODILY INJURY(Peracddent) $ PSCHEDULED HIRED AUTONON-OWNED S AUTOS PR TY DAMA (Per acadent) $ $ A UMBRELLA LIAR X OCCUR Y Y EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 EXCESS LIAR CLAIMS -MADE 12 EMX 71966 01 10/01/12 10/01/13 DED RETENTION $ $ WORKERS COMPENSATION q - H- AND EMPLOYERS' LIABILITY YIN R E. L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) It yes, desctlbe under NIA E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A CONTRACTOR'S POLLUTION LIABILITY MOLD OPS-OCCURRENCE FORM PROFESSIONAL LIABILITY -CLAIMS MADE FORM Y _ Y _ 12 EMP 71965 01 10/01/12 10/01/13 $1,000,000-MOLD LIMIT -PER CLAIM $1 00,DDD- MOLD AGGREGATE $1.W0,000 - PER CLAIM DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) RE: WATER UTILITIES, 700 WOOD STREET, FORT COLLINS, CO AS REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT, THE CERTIFICATE HOLDER IS INCLUDED AS ADDITIONAL INSURED FOR ONGOING OPERATIONS UNDER GENERAL LIABILITY WITH RESPECT TO THE ABOVE REFERENCED. CITY OF FORT COLLINS ATTN: PURCHASING P.O. BOX 580 FORT COLLINS, CO 80522-0580 ZLO] 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 reserved a ,w as IcV rwua) i ne ACUFIO name and logo are registered marks of ACORD