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HomeMy WebLinkAbout365211 WESTERN ECOSYSTEMS TECHNOLOGY INC - INSURANCE CERTIFICATE (3)WESTECO-01 SPRAKASH ACORO CERTIFICATE OF LIABILITY INSURANCE DAT2I3I2015E(MM/DYY) `-� 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 ICONTACT INSURED Services LLC ne, WY 82001 Western Ecosystems Technology Inc. 415 W. 17th Street, Suite 200 Cheyenne, WY 82001 635-4231 INSURERS AFFORDING COVERAGE NAI INSURER A: Hartford Casualty Insurance Company 29424 INSURER B : Sentinel Insurance Company Ltd. 11000 INSURER c : Alterra America Insurance Company 21296 INSURER D: Commerce & Industry Insurance Company 19410 INSURER E: Continental Casualty Company 20443 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 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 INSURANCEADDLISUSIR POLICY NUMBER POLICY EFF MMIDD POLICYXP MMMD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OOCCUR 34UUNAQ9132 02/03/2015 02/03/2016 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea oNTED e $ 300,00 X MED EXP (Any one Person) $ 10,00 PERSONAL& ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: POLICY I JET LOC GENERAL AGGREGATE $ 2,000,00 PRODUCTS-COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident)$ 1,000,0 B ANYAUTO L"09132 MUMS 0210312016 BODILY INJURY (Per Person) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS J AUTOS X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ J( UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000, AGGREGATE $ 10,000,000 C EXCE5S LIAR CLAIMS -MADE MAXA3EC500001435 02/03/2015 02/03/2016 DIED X RETENTION$ 10,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICERWEMBER EXCLUDED? (Mandatory in NH) N yes, describe under DESCRIPTION OF OPERATIONS below NIA 66456076 04/04/2014 04/ON2015 X SPER OTH- TATl1TE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYE $ 1,000, E.L. DISEASE - POLICY LIMIT $ 1,000,000 E Professional Liab 59237011 04/022014 04/02/2015 See Attached DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Reentries Schedule, may be attached if more spa" Is required) Project #391-06.001, Project Name: Ha((iganSeaman.WorkOrderHS-6 POLICY TYPE: Auto Liability CARRIER: James River Insurance Company POLICY TERM: 02/03/2015 - 02/03/2016 POLICY NUMBER: CA4360016301 Hired and Non -Owned Auto Combined Single Limits: $1,000,000 SEE ATTACHED ACORD 101 City of Fort Collins 700 Wood Street Fort Collins, CO 80521 l ANY CLLA 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 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: WESTECO-01 LOC #: 1 A�R� ADDITIONAL REMARKS SCHEDULE SPRAKASH Page 1 of 1 AGENCY NAMEDINSURED USI Insurance Services LLC Western Ecosystems Technology Inc. 415 W. 17th Street, Suite 200 Cheyenne, WY 82001 POLICY NUMBER SEE PAGE 1 CARRIER NAIC CODE SEE PAGE 1 SEE P 1 EFFECTIVE DATE: SEE PAGE 1 THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance Description of Operations/Locations/Vehic POLICY TYPE: Professional Liability CARRIER: Continental Casualty Company POLICY TERM: 04/02/2014 — 04/02/2015 POLICY NUMBER: 592376511 Claims Made Form Per Claim: $5,000.000 Aggregate: $5,000,000 Deductible: $25,000 POLICY TYPE: Workers Compensation - CA CARRIER: Markel American Insurance Company POLICY TERM: 04/04/2014 — 04/04/2015 POLICY NUMBER: 66456077 Statutory $1,000.000 Each Accident $1.000,000 Disease — Policy Limit $1,000,000 Disease — Each Employee POLICY TYPE: Stop Gap/EL CARRIER: Hartford Casualty Insurance Company POLICY TERM: 02/03/2015 — 02/03/2016 POLICY NUMBER: 34UUNAQ9132 WY, ND, WA & OH Stop Gap Liability $1,000,000 - Ea Employee $1,000,000 - Ea Occurr $1,000,000 - Aggregate Policy #66456077 provides coverage for the State of California. HGUKU IV] IzuutscUll (J 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD