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HomeMy WebLinkAbout389317 PROCTOR ENGINEERING GROUP LTD - INSURANCE CERTIFICATE (2)® A� o CERTIFICATE OF LIABILITY INSURANCE DATE IMMIDDIyYYY) 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 poiicy(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 Santa Marla & Company 1550 Parkside Drive Suite #200 Walnut Creek, CA 94596 wWw.smcdsk.com , CONTACT NAME: Cenificale Department PHONE AIC, No E,U:92R- 5 -76QQ_ AC No: E-MAIL ADDRESS: r-,enirtcateS,@-mcrisk.co INSURERS AFFORDING COVERAGE HAIG0 INSURER A: VRIIPV Fnm0_WManGComPany_ INSURED Proctor Engineering Group, LTD 418 Mission Ave. San Rafael CA 94901 INSURER B INSURER C: INSURER D: INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 17115130 REVISION NUMBER: V 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 LTR TYPE OF INSURANCE INc-SUBR POLICY NUMBER MMIDIDIYYYY MMIDDIYYYY LIMITS GENERALLIABILITY EACHOCCURRENCE $ PREMISES TORENTED $ COMMERCIAL GENERAL LIABILITY MED EXP (Anyone person) $ CLAIMS -MADE OCCUR PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ $ POLICY PRO- LOCI AUTOMOBILE LIABILITY Ea e¢LentSINGLE LIMIT S BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOSAUTO NON -OWNED HIRED AUTOS AUTOS BODILY INJURY (Per accident) S PROPERTY DAMAGE PerecGdeel $ $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED RETENTIONS $ S 8 A WORKERS COMPENSATION AND EMPLOYERS ' LIABILITY Y I ry ANY PROPRIETORIPARTNE R/EXECUTIVE❑ 5085230146 7/1/2013 7/1/2014 TORYu ITSSTU D� E.L. EACH ACCIDENT $ 1000000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) NIA E.L. DISEASE - EA EMPLOYEE $ 10nnnnp E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below A Workers Compensation- FL NV KS 5085230194 7/1/2013 7/1I2014 Statutory limits for FL, NV, KS DESCRIPTION OF OPERATIONS I LOCATION I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, It more apace Is regul red) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box b80 AUTHORREDREPRESENTATIVE Fort Collins MO 80522 /jam Cad A. Santa Maria ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD CERT NO.: 17115130 Heather De Piero 7/25/2013 10:23:11 AM Page 1 Of 1