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125216 WALSH ENVIRONMENTAL SCIENTISTS & ENGINEERS - INSURANCE CERTIFICATE (2)
ECOL&EN-01 JONESCM CERTIFICATE OF LIABILITY INSURANCE DAM81212 D/YYYV) 1 I2I2013 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 endomement(s). PRODUCER Willis of New York, Inc. c/o 26 Century Blvd. P.O. Box 305191 Nashville, TN 37230-5191 CONTACT NAME: PHONE 877 945-7378 FAX (Alc, No Ert : ( ) INC, NO: (868) 467-2378 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE I NAIL# INsu RERA: Great Divide Insurance Company 25224 ^� INSURED '✓'�` INSURER B: Federal Insurance Company 20281 INSURER O: Walsh Environmental Scientists & Engineers, LLC INSURER D 4949 Pearl E Circle, Suite 300 Boulder, CO 80202 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADOLTSUBR LTR INSR)-WVO POLICY EFF POLICY EXP POLICY NUMBER IMWOD�MI°OttYYY) LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EACH OCCURRENCE $ 3,000,000 IGLP200597711 8/1/2013 811/2014 DAMAGES Ea occ nn PREMISES RENT oence $ $00,000 MEp EXP (Any one person) E 30,000 PERSONAL &ADV INJURY S 3,000,000 GENERAL AGGREGATE S 3,000,000 GEN-L AGGREGATE LIMIT APPLIES PE R: PRODUCTS - COMPIOP AGG $ 3,000,000 POLICv X PE POLICY X L. EMPLOYEE BENEFI $ 1,000,000 AUTOMOBILE LIABILITY EO emCeD SINGLE LIMIT E 1,000,000 X BO°ILYINJURY(Per person) $ A ANY AUTO BAP200598311 811/2013 8/1/2014 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per acddenl 1 E HIRED AUTOS AUTOSSWNED PROPERTY OHMAGE PER ACCIDENT I$ I$ LIAR XXCESS OCCUR EACH OCCURRENCE $ 15,000,0001 B KMBRELLA LIAR CLAIMS -MADE 79$72763 8/1/2013 8/1/2014 AGGREGATE E 5,000,00011 ED IX I RETENTIONS 10,000 Prod/Comp)Ops $ 15,000,000 WORKERS COMPENSATION ANDEMPLOYERS.UABILITY YIN ANY PROPRIETORMARTNER/ ECUTIVE OFFICER?AEMBER E%CLUDEDi NIA 1W STATU- OTH- TORY LIMITS R E.L. EACH ACCIDENT I $ E.L. DISEASE -EA EMPLOYEE $ (Mandatory in IN under If ySCRIP E. L. DISEASE - POLICY LIMIT $ ION DESCRIPTION OF OPERATIONS Oelov DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Adace Additional Remarks schedule, it more space is required) RE: Professional Services Agreement Work Order Ty 7436 vironmental Services. CERTIFICATE HOLDER 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. City of Fort Collins AUTHORIZED REPRESENTATIVE Attn: Carol Webb PO Box 580 Fort Collins CO 80522 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD ECOL&EN-01 JONESCM vwir� CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDY YY) 812/2013 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 endomement(s). PRODUCER Willis of New York, Inc. c/o 25 Century Blvd. P.O. Box 305191 Nashville, TN 37230-5191 CONTACT NAME: PHONE FAx LAID, No Ext): (877 ) 945-7378 A/C No): (ggg ) 467-2378 E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC Y INSURER A: Great Divide Insurance Company 2522Q INSURED INSURER B: Federal Insurance Company 20281 INSURER C: Walsh Environmental Scientists & Engineers, LLC INSURERD: 4949 Pearl E Circle, Suite 300 Boulder, CO 80301 INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD - INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO 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 BE OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, INSR ADDL SUBR POLICY EFF POLICY E%P LTR TYPE OF INSURANCE IN_$R WVD POLICY NUMBER MMIDDIYYYY MMIDDIYYYY LIMITS GENERAL UABIUTY URRENCE $ 3,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR GLP200597711 8/1/2013 81112014 DAMAGEaoo, T Ea oaurrence $ 500,000 Any one parson) $ 30,OOD &ADV INJURY WAGGREGATE I 3,000,000 GGREGATE $ 3ruin000' GEN'LAGGREGATE LIMIT APPLIES PER'. PDLCY X PEc°T n 00 -COMP/OPAGG $ 3,000,000' EE BENEFI I 1,000,000 A AUTOMOBILE X LIABILITY ANY AUTO BAP200598311 8/1/2013 8I1/2014 EO BINEDtSINGLE LIMIT $ 1,000,000 BODILYINJURY(Perperson) s ALL GAINED SCHEDULED AUTOS AUTOS BODILY INJURY (Per acudent) s HIRED AUTOS NON -OWNED AUTOS FPFOPERTY DAMAGE PER ACCIDENT $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 15,000,000' X AGGREGATE $ 15,000,000 B EXCESS LIAB CLAIMS -MADE 79872763 8/1/2013 8/1/2014 DED X RETENTION$ 10,000 Prod/Compl Ops $ 15,000,000; WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? N/A WC WATU- OTH- TORY LIMITS ER E. L. EACH ACCIDENT $ E L. DISEASE- EA EMPLOYEE $ (Mandatory in NH) Ryyes, desaibe under DESCRIPTIONOFOPERATIONS below E L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schad If more ce is required) The Excess Liability policy supports the General Liability and Automobile Liability. E: P1058 E vironmental Services ---The City of Fort Collins is named as an additional insured on the general liability as required by written contract. City of Fort Collins 215 North Mason Street P.O. Box 580 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 AL,VKU ZO tZUIU/W) © 1988-2010 the ACORD name and logo are registered marks of ACORD All rights reserved