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HomeMy WebLinkAbout454406 BIOHABITATS INC - INSURANCE CERTIFICATE (3).ft. � R CERTIFICATE OF LIABILITY INSURANCE 12/19/2014 DATE (MM DD14 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 Klein Agency, LLC. P.O. BOX 219 _ Timonium ND 21094 CONTACT NAME: PHONE (Q10)832-7600 EA% (410)832-1849 E-MAIL INSURERIS) AFFORDING COVERAGE NAIC as INSURER A:Natlonal Surety Co INSURED Biohabitats, Inc. 2081 Clipper Park Road Baltimore hID 21211-1406 INSURER B.American Automobile Ins. Co. INSURER C:Travelers Casualty b, Surety Co INNsUuREContinentail CasualtyCompany RERE: INSURERF: COVERAGES CERTIFICATE NUMBER:15-16 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 LTR TYPE OF INSURANCE ADDL SUER POLICYNUMBER POLICY EFF MM/ 0 POLICY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR IUBCSO901809 /1/2015 /1/2016 MED EXP("ana person) $ 10,000 PERSONAL S ADV INJURY $ 2,000,000 X Contractural Liability GENERAL AGGREGATE $ 4,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY X PRO LOC $. AUTOMOBILE LIABILITY Ea COMBINEDSIN LE LIMB 1 000 000 X BODILY INJURY (Per person) $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS IOM80309829 /1/2015 /1/2016 BODILY INJURY( Per accident) $ PROPERTY DAMAGE Per acckiem $ NON OMED HIRED AUTOS AUTOS - X 4 UMBRELLA DAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB CLAIMS -MADE C80901809 /1/2015 /1/2016 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A UB4213TB94 1 States Coverage nrlorsement /1/2015 /l/2016 XI WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 11000,000 If vas, deecnbe under DESCRIPTION OF OPERATIONS below is a covered State E.L. DISEASE - POLICY LIMIT 1 $ 1 OOD 000 D Professional Liability ECK288389268 /1/2015 /1/2016 Each Claim $5,000,000 Aggregate $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (Attach ACORD 101, AddlUonal Remarks Schedule, If more apace Is required) Project: I-25 Wetlands Biohabitats Project: 12904-01 See attached for specific additional insured wording. City of Fort Collins, Colorado Attn: John Stephen P.O. BOX 508 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 Justin Klein/LISA -0 4D1988-2010 ACORD CORPORATION. All rights reserved. INS025 (201005),01 The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS If required under an insured written contract, executed prior to any loss, City of Fort Collins, Colorado are an Additional Insured under the General Liability Policy, but only with respects to liability arising from work performed by or on behalf of Biohabitats, Inc. If required under an insured written contract, executed prior to any loss, City of Fort Collins, Colorado are an Additional Insured under the Automobile Policy, but only with respects to liability arising from the operation of vehicles by employees of Biohabitats, Inc. If required under an insured written contract, executed prior to any loss, Waiver of Subrogation is provided for City of Fort Collins, Colorado under the General Liability, Automobile Liability and Workers Compensation Policies. It is further understood that coverage provided the Additional Insured under the General Liability and Automobile Liability shall be primary and non-contributory to any other coverage available to the Additional Insured. ' OFREMARK COPYRIGHT 2000, AMS SERVICES INC. ' ACOR" CERTIFICATE OF LIABILITY INSURANCE �� DATE(MMIOO/YYYY) 12/19/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OFINFORMATIONONLY 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 endorsements . PRODUCER Klein Agency, I.I.C. P.O. .BOX 219 Timonium MD 21094 CONTACT NAME: PNONE (410)832-7600 FAX AID Na, (a10)$32-SBa9 E-MAIL INSURERS AFFORDING COVERAGE NAIC# INSURER A.'National Surety CO INSURED Biohabitats, Inc. 2081 Clipper Park Road Baltimore MD 21211-1406 INSURER BAmerl can Automobile Ins. Co. INSURER C:Travelers Casualty f. SuretV CO INSURERD:Contlnental Casualtv Company INSURER E: INSU RER F: COVERAGES CERTIFICATE NUMBER:15-16 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. INSR LTR TYPE OF INSURANCE ADDL SU.. POUCY NUMBER POUCY EFF MM/ODrYYYYI POLICY EXP (MM/DOIYYYYI UNITS GENERAL UABILITY EACH OCCURRENCE $ 2,000,000 PREMISES Ea occurrence $ 1,000,000 X COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE f X1 OCCUR ABC80901809 /1/2015 /1/2016 MED EXP("we person) $ 10,000 PERSONAL B ADV INJURY $ 2,000,000 X Contractural Liability GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4,000,000 POLICY X PFrITRO LOC $ AUTOMOBILE UABILITY EMBINEDmicittimt SINGLE LIMIT 11000,000 X BODILY INJURY (Per person) $ B ANY AUTO BODILY INJURY ' OWNED SCHEDULED 0309829 /1/2015 /1/2016 ALL AUTOS I (Par accident) $ NON -OWNED PROPERTY DAMAGE Per accident) $ HIREDAUTOS AUTOS $ X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS UAB CLAIMS -MADE ABC80901809 /1/2015 /l/2016 DEO I I RETENTION $ $ WORKERS COMPENSATION US4213TS94 X WC STATU- OTH- AND EMPLOYERS' LIABILITY YINAll E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE States Coverage C Mandatary FEMBER EXCLUDED? in NH) NIA Endorsement /1/2015 /1/2016 E.L. DISEASE - EA EMPLOYE $ 11000,000 /yes. describe under DESCRIPTION OF OPERAI IONS halo« A i covered Stato E.L. DISEASE -POLICY LIMIT $ 1,000,000 D Professional Liability CH288389268 /1/2015 /1/2016 Each Claim $5,000,000 Aggregate $5, 000, 000 DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ANach ACORD 101, AddlOonal Remarks Schedule, N more space Is required) See attached .for specific additional insured wording. Project: 7616 Wetland, River 6 Floodplain Ecological Restoration. City Of Fort Collins 215 N Mason Fort Collin, 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 Klein/LISA ` ©1988.2010 ACORD CORPORATION. All rights reserved INS025 (20100e),01 The ACORD name and logo are registered marks of ACORD COMMENTS/REMARKS If required under an insured written contract, executed prior to any loss, the City of Fort Collins are Additional Insured under the General Liability Policy, but only with respects to liability arising from work performed by or on behalf of Biohabitats, Inc. If required under an insured written contract, executed prior to any loss, the City of Fort Collins are Additional Insured under the Automobile Policy, but only with respects to liability arising from the operation of vehicles by employees of Biohabitats, Inc. - If required under an insured written contract, executed prior to any loss, Waiver of Subrogation is provided for the City of Fort Collins under the General Liability, Automobile Liability and Workers Compensation Policies. It is further understood that coverage provided the Additional Insured under the General Liability and Automobile Liability shall be primary and non-contributory to any other coverage available to the Additional Insured. OFREMARK COPYRIGHT 2000, AMS SERVICES INC.. I