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HomeMy WebLinkAbout109888 INSITUFORM TECHNOLOGIES INC - INSURANCE CERTIFICATE (14)lft. O CERTIFICATE OF LIABILITY INSURANCE � 7n/zola DATE(MMIDD/YYYV) 6/20/2013 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 St. Louis Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 PADDRESS h o CONTACT IN A/c No, EXt : aC No E-MAIL INSUREWSH AFFORDING INSURER A: LibcnyAfmuilFran velnsuceComparry(64) 23035 INSURED Insituform Technologies, LLC 1041932 fka lnsituform Technologies, Inc. 17988 Edison Avenue Chesterfield MO 63005 INSURER B : Liberty Insurance Corporation (64) 42404 INSURER C: INSURER D COVERAGES INSTE02 CERTIFICATE NUMBER: 3731 S97 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 BYPAIDCLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF M/ POLICY EXP MMI LIMITS A GENERAL LIABILITY Y N TB2-641-004218-033 7/1/2013 7/1/2014 EACH OCCURRENCE 2,000,000 A A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR BROAD FORM PD/CONTRAC PER PROJECT AGG. CAP $20r, UAL DAMAGE TO RENTED PREMISES Ee occurrence 350,000 MED EXP AFy one mon 10,000 PERSONAL It ADV INJURY s 2 000 000 X IndeDendt Contractor X XCU GENERAL AGGREGATE s 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 4000000 POLICY[ X PRO- JECT T S A AUTOMOBILE LABILITY Y N AS2-641-004218-023 7/1/2013 7/1/2014 EOMBB ANdEeDISINGLE LIMIT S 2000000 X BODILY INJURY (Per Person) $ X'X'X'XXXX ANY AUTO AUTOWNED SCHEDULED AUTOS BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE S X}QCXXXX HIRED AUTOS NON -OWNED $ }{XXXXXX UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXxX�' x EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED I I RETENTION $ $ B B WORKERS AND EMPLO ERS'LABILOITV ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFILE"EMBER EXCLUDED? O IMandatory,n NMI It yes desrnce ender DESCRIPTION OF OPERATIONS.1. N / A N WA7-64D-009004-443 WC7-641-004218-013(WI) 7/1/2013 7/1/2013 7/1/2014 7/1/2014 X TORYLIMITS OTH- EL. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1000000 E.L. DISEASE -POLICY LIMIT it 1 000MO DE WTI OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101. Additional Remarks Schedule, if more space is required) = P-763 IPP SANITARY AND STORM SEWERS (3RD YEAR OF TERM)). THE CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND E S ARE ADDITIONAL INSUREDS UNDER GENFRAL LIABI LI'N AND AUTOMOBILE LIABILITY AS REQUIRED BY WRITTEN CONTRACT, BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE NAMED INSURED-S OPERATIONS. XX CtK I IF ICA I It HOLUtH CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3731597 AUTHORIZED REPRESENTATIVE CITY OF FORT COLLINS 215 N. MASON STREET FORT COLLINS CO 80524 ACORD 25 (2010105) ©1988- CORD CO ORA N. All rights reserved The ACORD name and logo are registered marks of ACORD ll CERTIFICATE OF LIABILITY INSURANCE �i 7nrzola DA6/20/DD13 6/20/2013 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 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 endomement(s). PRODUCER Lockton Companies,LLC-1 St. Louis Three City Place Drive, Suite 900 St. Louis MO 63141-7081 (314) 432-0500 CONTACT NAME: FAX NC No E,d : NC No E-MAIL ADDRESS' INSURERSI AFFORDINGCOVERAGE N IC# INSURER A: Lil,crty Mulud Fire Insurance Company(,H) 23035 INSURED Insituform Technologies, LLC 1041932 fka Insituform Technologies, Inc. 17988 Edison Avenue Chesterfield MO63005 INSURER B: Liberw Insurance Corporation (64) 42404 INSURERC: INSURER D INSURER E: INSURER F: COVERAGES INSTE02 CERTIFICATE NUMBER: 2660597 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. L T R TYPE OF INSURANCE ADDL SUBRINSR IWD NUMBER POLICPOLICY MMfDlD EFF POLICY EXP LIMITS A GENERAL LIABILITY Y N TB2-641-004218-033 7/1/2013 7/1/2014 EACH OCCURRENCE 2000000 A '4 X COMMERCIAL GENERAL LIABILITY I CLAIMS -MADE NIOCCUR BROAD FORM PD/CONTRAC PER PROJECT AGG. CAP S20N UAL DAMAGE TO RENTED PREMISES aoccurrence 350 000 MED EXP An one erson 10,000 PERSONAL & ADV INJURY s 2,000,000 X Indeoendl Contractor X XCU GENERAL AGGREGATE s 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s 4000000 PRO - POLICY X E T L S A AUTOMOBILE LIABILITY Y N AS2-641-004218-023 7/1/2013 7/1/2014 COMBINED SINGLE LIMITEa nt s 2000000 X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO ALL AUTOS NED AUTOSULEO BODILY INJURY (Per accitlenl $ XXXXXXX ERDAMAGE r c $ XXXXXXX HIRED AUTOS NON -OWNED AUTOS $XXXXXXX UMBRELLA LIAB OCCUR EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED I I RETENTION $ $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER,EXELl1TIVE ❑N/A OFFICEWNEMBER E%CLUDED? N (Maneatoryin NH) If Cu een4e urger D DESCRIPTION OF OPERATIONS Oelcw N WA7-64D-009004-13 WC7-641-004218-013 (WO 7/1/2013 7/1/2013 7/1/2014 7/1/2814 WC STATU- OTH- X TRY LIMIT E.L. EALNALLIDEM $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1 000 000 EL DISEASE - POLICY LIMIT 1,000,000 DE GRIP F OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required) R :_ P-1022, URED-IN-PLACE PIPE SANITARY AND STORM SEWERS. THE CITY OF FORT COLLILNS, ITS OFFICERS, AGENTS AND E ARE ADDITIONAL INSUREDS UNDER GENERAL LIABILITY AND AUTOMOBILE LIABII.I'I'Y AS REQUIRED BY W121'I-I-EN CONTRACT, BU'F ONLY WITH RESPECT'FO LIABILITY ARISING OUT OF THE NAMED INSURED'S OPERATIONS. XX L.CK I HI ILA I C MULUCK L:ANL:CLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2660597 AUTHORIZED REPRESENTATIVE CITY OF FORT COLLINS 215 N. MASON STREET FORT COLLINS CO 80524 ACORD 25 (2010/05) ©1988- CORD CO ORA N. All rights reserved The ACORD name and logo are registered marks of ACORD