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Home My WebLink About486984 LAYNE INLINER LLC - INSURANCE CERTIFICATE (3)aco120° CERTIFICATE OF LIABILITY INSURANCE �� sn/zma OADDIYYYY) 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 policyties) 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 M0 64112-1906 (816) 960-9000 VL CONTACT AIC No Ea[ : A/C No E-MAIL INSURERfS1 AFFORDINGCOVERAGE NAICa INSURER A: Zurich American Insurance Company 16535 INSURED LAYNE INLINER, LLC 1054252 1775 EAST 69TH AVENUE DENVER CO 80229 INSURER B: American Guarantee and Llab. Ins. Co. 26247 INSURER C : INSURER F COVERAGES LAYIN01 CERTIFICATE NUMBER: 10726004 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLM LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR X CONTRACTUAL Y N GLO 5817438-00 5/1/2013 5/1/2014 EACH OCCURRENCE 2,000,000 PRE MI ETO RENTED nce SOO OOO MED EXP (Any one rson 10,000 PERSONAL 8 ADV INJURY $ 2,000,000 X X,C,U COVERAGE GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE X POLI V LIMIT APPLIES PER: JET L PRODUCTS AGG $ 5,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEpDULED HIRED AUTOS X gOTO$WNED N N BAP 5817437-00 5/1/2013 5/1/2014 COMBINED SINGLE LIMIT Ea accident $ 5,000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX X PBOPERde DAMAGE $XXXXXXX $XXXXXXX B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N I UMB380788609 5/12013 5/1/2014 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1 00O 000 DED I I RETENTION $ $ XXXXXXX A A A NSATION WORKERAND EMPSO ERSELABILIITY ANY PROFRIETOP]PARTNEwEXEcurNE YIN OFFICER]MEMBER EXCLUDED? EHI 'Mandalory In NH) DESCRIPTION OF OPERATIONS below DES;ceunoe OFF NIA N WC 51 7419-00 AOS) WC 5817440-00 WI) STOPGAP(ND,Q I,WA,WY) 5/1/2013 5/I/2013 5/1/2014 5/1/2014 X TNRvuMT1 OTH- E.L EACH ACCIDENT $ S OlO1lO1 EL.DISEASE -EA EMPLOYEE lO�QD 5,000,000 5,000000 E.L. DISEASE - POLICY LIMIT 5000000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF FORT COLLINS, COLORADO IS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY COVERAGE, ONLY AS REQUIRED BY CONTRACT, SUBJECT TO THE TERMS AND CONDITIONS OF T'116 POLICY, 10726004 CITY OF FORT COLLINS, COLORADO 4316 LAPORTE AVE. 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. ACORD The ACORD name and logo are registered marks of ACORD