HomeMy WebLinkAbout468473 VEOLLA ES TECHNICAL SOLUTIONS LLC - INSURANCE CERTIFICATEAFRO® CERTIFICATE OF LIABILITY INSURANCE
DATE(MM10°YYYY)
1 Z'31i2013
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
OT
NAME,
Marsh USA, Inc,
PHONE FAX
AAM, No. 511kAIC No
540 W. Madison Street
E-MAIL
Chicago, IL 60661
Ath Vedia.CertRequesb@marsh.cam I Fax 212-948-5053
WSURE 8 AFFORDING COVERAGE
NA1ca
INSURER A: ACE American Insurance Company
22667
LOM•
INSURER B : Illinois Union InsulaKe Company
2796D
INSURED ^ /
Technical Solutions, LLC
Venia700lE lTechnicalC
INSURER C : WA
N/A
Road, Suite 201 O
Fast Suit
East 1 _ ���
INSURER D :
Lombard, IL 60148
INSURER E :
INSURER F :
CERTIFICATE NUMBER' CHI-00479526o-13 REvlalvna nUMBE c:6
COVERAGES
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�Tp
A
TYPE OF INSURANCE
GENERAL UABIUTY
X COMNnABI AL GENERAL LIABILITY
CIAIMSADE M OCCUR
AI
pL
POLICY NUMBER
HOD G27329950
POLICY EFF
M
OV0112014
POLICY EXP
M/ O
0110112015
LIMITS
EACH OCCURRENCE
S 5,000,000
AMA N
PREMISE t
S 1,0D0,000
MED EXP An one
$ 10,000
PERSONAL S AOV INJURY
S 5,000,000
rGENLGGREGATE
GENERAL AGGREGATE
$ 25,OOD,ODO
LIMIT APPLIES PER:
PRODUCTS-COMPIOP AGG
$ 10,000,000ICY
COMBINED SINGLE LIMI
Ea accident
$
$ 5,000,000
A
PRO- LOC
AUTOMOBILE UABBUTY
IBA FK)MI661A
01/0112014
01101/2015
BODILY INJURY (Par Person)
$
X ANV AlfTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS PAUTOS
BODILY INJURY (Perecdeart)
S
PR
OPERTY DAMAGE(Per accident)
$
It
UMBRELLA Me
OCCUR
EACH OCCURRENCE
$
AGGREGATE
i
ExCE68 UAB
CLAIMS -MADE
DED I RETENTION
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY yI N
ANY PROPRIETOWPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
(Mandatory in Nil)
If yes, describe under
DESCRIPTION OF OPERATIONS below
vJc CR,$TATU- oTH-
S
A
A
NIA
R C47877891 (ADS)
SCF C4787788A Retro
) ( )
01101I2014
01/07/2014
1 12015
O1N72015
E.L. EACH ACCIDENT
1,000,0U0
$
E.L. DISEASE - EA EMPLOYEE
$ 1'0off'wo
E.L. DISEASE - POLICY LIMIT
S i'�'�
B
Prof Liability/Claims-Made
GOO G27269M 001
07/01/2013
01101IN016
Each Occunmce 1,000,000
Contractors' Poll Occurrence
SIR: $100,000
Aggregate 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Allach ACORD 101, Additional Roma" Schedule, B more apace Is required)
City of Fort Collins is included as additional insured (except as respects all coverage afforded by Workers' Compensation and professional liability) Where required by WdBen contract but only for liability arising out of
the operations of the named insured, A Waiver of subrogation is granted as required by Milan contract but Only for liability arising out of the operations of the named insured.
City of Fat Collin
P.O. Bolt 580
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.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Manashi MukherjeeA�^��
(C) 1999-2010
ACORD 25 (2010106) The ACORD name and logo are registered marks of ACORD
All rights