HomeMy WebLinkAbout389317 PROCTOR ENGINEERING GROUP LTD INC - INSURANCE CERTIFICATE (5)rnor,rft• 1n5s
PROCTENGI
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
12/15/2014
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. .. .. ;I. '.',..,
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 _'
CONTACT - -
NAME:
Dealey, Renton & Associates
P. O. Box 12675 Attn: KXC
Oakland, CA 94604-2675
HON o E , , 510 4653090 uN, ; 510 452-2193
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAICA
INSURER A: Sentinel Insurance Co. LTD
11000
510 465-3090
INSURED
Proctor Engineering Group, LTD, Inc.
418 Mission Avenue
San Rafael, CA 94901
-
INSURER B: U.S. Specialty Insurance Compan
29599
INSURER C
INSURER D
INSURER E
INSURER F:
r:nVFRArFS 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.
LTRR
TYPE OF INSURANCE
INSRL
wVD
POLICY NUMBER
MM/DDY EFF
MM/DD EXP
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
X Contractual
57SBWKB6012
- "-�
1/18/2015
-
01/18/201
EEpACH�OCCURRENCE
s2000000
PREMISES EaE nre
$1 OOO OOO
MED UP (An one Person)
$10000
PERSONAL B ADV INJURY
f2000000
Liability Included
GENERAL AGGREGATE
s4,000 000
GEN'L AGGREGATE LIMIT APPLIESPER.
—]POLICY X PRO- JECTLOC,
PRODUCTS-COMPIOP. AGO
s4,000000.
$
A
AUTOMOBILELIABILITY
X ANY AUTO
ALL OWNED. SCHEDULED
AUTOS AUTOS
NON-OWNED
X HIRED AUTOS X AUTOS
57UEGUL0680
2/16/2014
12/16/2015
EOM�BBIINdEEDtSINGLELIMIT
1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Peraccidenl
$
$
A
X
UMBRELLALLAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
57SBWKB6012
1/18/2015
01/18/2016
EACH OCCURRENCE
$3000000
AGGREGATE
s3,000,000
DED I X RETENTION $10000
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOWPARTNER/EXECUTIVE YIN
OFFICEWMEMSER EXCLUDED? .❑.
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below_�t
N/A
_
I
WC STATU- OTH-
E.L. EACH ACCIDENT
$
E.L. DISEASE. EA EMPLOYEE
$
E.L. DISEASE- POLICY LIMIT
$
B
Professional
Liability
USS1425017
6/17/2014
06/17/201
$2,000,000 per claim
$4,000,000 annl aggr.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
General Liability policy excludes claims arising out of the performance of professional services.
All operations of the named insured.
CI of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS.
P. O. Box 580
Fort Collins, CO 80522-0000 AUTHORIZED REPRESENTATIVE
w 1-JOo-Lu IY M1 Vnu MVnrVR 11VIY. XII I19.131ubuiYCu.
ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S1197345/M1197342 NXS