Press Alt + R to read the document text or Alt + P to download or print.
This document contains no pages.
HomeMy WebLinkAbout110168 U S ENGINEERING COMPANY - INSURANCE CERTIFICATE. ks. R CERTIFICATE OF LIABILITY INSURANCE
�� 7/3u2ola
DA7/24/DDrrYYY)
7/24/2013
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(les) 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. 47tt1 Street, Suite 900
Kansas City MO 64112-1906
(816)960-9000
A/C No Ext : FAX
A/C No
E-MAIL
INSURERS)COVERAGE
C
INSURER A : Liberty Mutual Insurance Company
23043
INSURED U.S. ENGINEERINGCOMPA Y
1354733 3433 ROANOKE
KANSAS CITY MO 64111
INSURERS: St. Paul Fire and Ma;neinsurance Company
24767
INSURER C :
D,
INSURER E,
INSURERINSURER
F•
CnVPRAr.PS I INF'.N( ill"i CFRTI9:ICATFMIIMRFI7. 11RRh'AQ7 DG\/1Q1nM M11RaDC0. YYYYYYY
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
Im
TYPE OF INSURANCE
ADDL
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/D
POLICY EXP
M/
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE O OCCUR
N
N
TB7-Z91457358-013
7/31/2013
7/31/2014
EACH OCCURRENCE
1,000,000
PREMISES (Ea RENTED)
$ 300,000
MED EXP (Any oneperson)
10,000
PERSONALS ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
s 21000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLI V X PE o X LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
AUTOWNED SCHEDULED
HIRED AUTOS USEO
N
N
AS2-Z91457358-033
7/31/2013
7/31/2014
COMBINED SINGLE LIMIT
Ea accident
$ 1 000 000
X
BODILY INJURY (Per person)
$ XXXXX
XX
BODILY INJURY (Per accident
$ XXXXXXX
PROPERTY errccdn
$ XXXXXXX
$XXXXXXX
B
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
N
N
ZUP-14S32357-13-NF
7/31/2013
7/31/2014
EACH OCCURRENCE
$ 5000000
X I
AGGREGATE
$ 5 000 000
DED RETENTION $
$ XXXXXXx
'4
WORKERS COMPENSATIONOTH-
AND EMPLO ERV LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFIC rory in NH)
(Mandatoryin NH) EXCLUDED?
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA A
N
WA2-Z9D-457358-023
7/31/2013
7/31/2014
X rNRVLIMlrS FR
E.L. EACH ACCIDENT
$ 1 OOO 000
E.L. DISEASE- EA EMPLOYEE
1000 000
E.L. DISEASE- POLICY LIMIT
1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES /(Attach ACORD 101, Additional Remarks Schedule, if more space is required)
All operations conducted by the insured.
Yf11\6rCLLM 1 1 V I\
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
11886393 AUTHORIZED REPRESENTATIVE
City of Fort Collins
P 0 Box 580
Fort Collins CO 80522
1 4 W144111,0
ACORD 25 (2010/05) ©9 8-2010 AC ORPORATION. All rights reserved
The ACORD name and logo are registered marks of ACORD