HomeMy WebLinkAbout389317 PROCTOR ENGINEERING GROUP LTD INC - INSURANCE CERTIFICATE (3)Client#: 1055
PROCTENGI
ACORD, CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDM )
12JO912013
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: U the certificate holder is an ADDITIONAL INSURED, the pdicy(fes) must be endorsed. IfSUBROGATION 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
Dealey, Renton 81 Associates
P. O. Box 12675 Attn: KXC
Oakland, CA 94604-2675
510 465-3090
INSURED
Proctor Engineering Group, LTD, tnc. 3 %13,
418 Mission Avenue
San Rafael, CA 94901
B: U.S. Specialty Insurance Compan
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 CONTRACTOR 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.
LTR
TYPE OF INSURANCE
IDOL
MAL
BU
MUD
POLICY NUMBER
MM D V EFF
MPOLICY EXP
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS-MAM Fx� OCCUR
X Contractual
57SBAKB6012
D111181W13
0IMSM14
EACH OCCURRENCE
s2,000,000
I obi enee
83OO OOO
MEDEXP (Ary a enan
$10000
PERSONAL S ADV INJURY
s2,000,000
Livability Included
GENERAL AGGREGATE
s4,000,000
GENL AGGREGATE LIMIT APPLIES PER:
POLICY X PRO- El LOG
PRODUCTS-COMP/OP AGG
f4000000
f
C
AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED SCHEDULED
AUTOS X HIRED AUTOS H
NOTION -OWNED
AUTOS
57UEGUL0680
1211612013
12/1612014
COMBINED SINGLE LIMIT
E. @ dent
BODILY INJURY(Per pe )
1 000 000
f
BODILY INJURY(Per acc400)
f
PROPERTY DAMAGE
f
f
A
X
uwBBELIA L"
EXCESS LIAR
X
OCCUR
CLAIMS -MADE
57SBAKB6012
1/16/2013
01118/201
EACH OCCURRENCE
f3 000 000
AGGREGATE
i3 000 000
LIED I X RETENTION 10000
f
WORKERS COMPENSATION
AND EMPLOYERS LABILITY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
e yea dasrnbeundw
DESCRIPTION OF OPERATIONS belm
NIA
WC STATU- OTH-
E.L EACH ACCIDENT
f
E.LDISEASE-FAEMPLOYEE
f
E.L CIS'cASC -POLICY LriIT
f
B
Professional
Liability
USS1324054
17/2013
7
06H7/2011
$2,000,000 per claim
$2,000,000 annl aggr.
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Addldonal Remark. Schedule, Blnore apace Is Inquired)
General Liability policy excludes claims arising out of the performance of professional services.
All operations of the named insured.
City of Fort Collins SHOELLED BEFOR
THEULD ANY EXPIRATTIIONHDATE VTHEREOFENOTICEIEWILL BEE DESCRD PLICS BE CDELIVERED NE
Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS.
P. O. Box 580
Fort Collins, CO 80522-0000 AUTHORIZED REPRESENTATIVE
w "00-1V 1 V MVVRV VVRt•VRI� I IVR. NII 11{),IILi ICiCI VCV.
ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S823268/M823265 NXSI:.;