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Home My WebLink About486984 LAYNE INLINER LLC - INSURANCE CERTIFICATE (2)Aco/20° CERTIFICATE OF LIABILITY INSURANCE sn/zol4 DADD/YYYY) 4/24//24/2013 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 Kansas City 444 W. 47th Street, $UI(e 900 Kansas City MO 64112-1906 (816)960-9000 rt UY ONTACT AM NC No Ext : A/C No E-MAIL ADDRESS' NAIC N INSURER A: Zurich American Insurance Company 16535 INSURED LAYNE INLINER, LLC 26 7915 CHERRYWOOD LOOP KIOWA, CO 80117 INSURER B: INSURER C: N RER E: INSURER COVERAGES LAYIN01 CERTIFICATE NUMBER: 12249603 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. ILTR TYPE OF INSURANCE INSR ADEL SUBR WVD POLICY NUMBER POLICY EFF MMI D POLICY EXP MLICYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR X CONTRACTUAL Y N OLD 5817438-00 5/1/2013 5/1/2014 EACH OCCURRENCE 2,000,000 PREMISESOE. Pecu ante 500,000 MED EXP (My oneperson) 10,000 PERSONAL a ADV INJURY $ 2,000,000 X X,C,U COVERAGE GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JECOT7 LOC PRODUCTS - COMP/OP AGG 8 5000000 $ A AUTOMOBILE LIABILITY ANY AUTO AUTOWNED AUTOS LED HIREOAUTOS X NON -OWNED Y N BAP 5817437-00 5/1/2013 5/1/2014 Ee eBBINEDSINGLE LIMIT $ 5,000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY(Per accident $ XXXXXXX X PROPERTY r $ XXXXXXX $XXXXXXX UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX DED I I RETENTION $ $ A A A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUThPE YIN OFFICEWMEMBEREXCLUDED? N❑ (Mandatory in NH) (M DESCRIPTION under Dyes. OF OPERATIONS below TION NIA N WC 5817439-00 (AOS) WC 5817440-00 ffi STOPGAP(ND,O ,6W(/A,WY) 5/1/2013 5/1/2013 5/1/2014 5/1/2014 WC STATU- OTH- X TORY LIMITSFR EL EACH ACCIDENT $ S OOOOOO EI_DISEASE -EA EMPLOYEE 5000000 EL DISEASE - POLICY LIMIT 5000000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: LAYNE JOB NCL 23603, 7106 CURED IN PLACE SANITARY SEWER STORMWATER MAINS REHABILITATION — FORT COLLINS CO; CHY OF FORT COLLINS IS INCLUDED AS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY AND AUTOMOBILE LIABILITY AS REQUIRED BY SIGNED, WRITTEN CONTRACT. 12249603 CITY OF FORT COLLINS PURCHASING DIVISION PO BOX 580 FORT COLLINS CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The ACORD name and logo are registered marks of ACORD acolRO CERTIFICATE OF LIABILITY INSURANCE5n/zo14 III 4/24//24/DA2013OD 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 endorsement(s). PRODUCER Lockton Companies, LLC-1 Kansas City 444 W. 47th Street, Suite 900 Kansas Cityy MO 64112-1906 (816)960-9000 CONTACT INC,No Ext : INC, No E- oAIL INS AFFORDING COVERAGE Cp INSURER A: Zurich American Insurance Company 16535 INSURED LAYNE INLINER, LLC 26 7915 CHERRYWOOD LOOP KIOWA, CO 80117 INSURER B: INSURERC: IN E INSURER COVERAGES 1.AYIN01 CERTIFICATE NDMRER- 11419995 RFVlgln?J NIIMRFR- 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 R TYPE OF INSURANCE ADDL SUER POLICY NUMBER PMEFF POLICY EXP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FRI OCCUR X CONTRACTUAL Y N OLD5817438-00 5/1/2013 5/I/2014 EACH OCCURRENCE 2000000 DAMAGE MTO RENTED FIRI a o urr oe 500,000 MED EXP (AnY oneperson) 10,000 PERSONAL 8 ADV INJURY $ 2,000,000 X X,C,U COVERAGE GENERALAGGREGATE $ 5 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLI Y PEOT L PRODUCTS - COMPIOP AGG $ 5,000,000 $ A AUTOMOBILE LIABILITY MYAUTOBODILY AUTOS NEO AUTOSULED HIRED AUTOS X AUTOSWNED N N BAP 5817437-00 5/1/2013 5/1/2014 Ee eanaeD SINGLE LIMIT s 5,000,000 X INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $XXXXXXX X PReOPP�Rd DAMAGE $XXXXXXX $XXXXXXX UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX OLD I I RETENTION $ is A A A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANY PROPRIETOWARTNEP/EXECOTrvE YIN OFFICERrMEMBEREXCLUDEOI N❑ (Mandatory In NH) DESCRIPTIONOF DESCRIPTION OF OPEPATIONS Mlon NIA N WC $817439-00 AOS ) WC 5817440-00 W1) STOPGAP(ND,O-LWA,WY) 5/1/2013 5/1/2013 5/1/2014 5/1/2014 T CS IMIT OTH- X EL EACH ACCIDENT s 5000000 EL DISEASE - EA EMPLOYEE 5000000 E.L. DISEASE - POLICY LIMIT 5000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES /(Anach ACORD 101, Additional Remarks Schedule, if more space is required) RE: FT. COLLINS, CO. 7106 CIP SANITARY SEWER STORMWATER MAINS REHAB. CERTIFICATE I10LDER IS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY COVERAGE, ONLY AS REQUIRED BY CONTRACT, SUBJECT TO TI IF TERMS AND CONDITIONS OP TI IB POLICY. 11412295 CITY OF FT. COLLINS PURCHASING DIVISION PO BOX 580 FT. COLLINS, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. the ACORD name and logo are registered marks of ACORD All rights reserved