HomeMy WebLinkAbout110168 U S ENGINEERING COMPANY - INSURANCE CERTIFICATE (2)ACOR6' CERTIFICATE OF LIABILITY INSURANCE
'%_/ 1/11/1015
DATE(MM/DD/YYYY)
1 7/22/2014
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 Lockton Companies
444 W. 47th Street, Suite 900
Kansas 'it MG 64112-1906
(816) 960-9000
CONTACT
INC,No Ezt : A/C No
E-MAIL
INSURER A: Liberty Mutual Insurance Company
23043
INSURED U.S. EN INEERING COMPANY
1354733 3433 ROANOKE
KANSAS CITY MO 64111INSURER
INSURERB: SLP-IFueandM e1ndudace Company
24767
NSURERC:
D
COVERAGES CERTIFICATE NUMBER: 11886191 REVISION NIIMRFR• XXXXXXX
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
T
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
POLICY EFF
IMMIDDNYYY
POLICY EXP
IMMIDDPYYYY
LIMITS
A
X
COMMERCIALGENERAL LIABILITY
CLAIMS -MADE � OCCUR
N
N
T187-Z91-457358-014
7/31/2014
7/31/2015
EACH
OCCURRENCE
2000000
DRA
MGETO aENTE once
300,000
MED EXP (Ary one rson
10,000
PERSONAL S ADV INJURY
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
POLICY[K]JEC 7LOC
OTHER
GENERAL AGGREGATE
s 41000,000
PRODUCTS - COMP/OP AGG$4000000
$
A
AUTOMOBILE
LABILITY
ANY AUTO
AUTOWNED AUTOS
HIREDAUTOS AUTO, WNEO
S
N
N
AS2-Z91457358-034
7/31/2014
7/31/2015
EOMBIINdEDtSINGLELIMIT
$ 1 000000
�{
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Per accident
$ }tj(}(X'j{}{}(
Pe0a ERZDAMAGE
$ xXX
Comp/Coll Deds.
$ 2,000
$
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
N
N
ZUP-51M1108-14-NF
7/31/2014
7/31/2015
EACH OCCURRENCE
s 5000000
X
AGGREGATE
$ 5, OOO O00
DIED I I RETENTION $
$ X'J(}{X'X'X'X'
p`
KERS COMPENSATION
AND EMPLO ERS'LABILIITY y./N
OFFICER/MEMBER E%CLUDED9 ECUTIVE
IMYandatory in NH)
es, de� M under
DESCRIPTION OF OPERATIONS below
N/A
N
WA2-Z9D457358-024
7/31/2014
7/31/2015
X ISTATUTE OTH-
E.L EACHACCIDENT
$ 1 000000
E.L. DISEASE - EA EMPLOYEE
1 000 000
EL. DISEASE -POLICY LIMIT
1000000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
All operations conducted by the insured.
11886393
City of Fort Collins
P 0 Box 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.
25 (2014101)
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