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HomeMy WebLinkAbout551825 COLORADO HAZARDOUS ENVIRONMENTAL - INSURANCE CERTIFICATECOHAZAR OP ID: SY ,4coRo CERTIFICATE OF LIABILITY INSURANCE DA 4/30/2 04/30/2015 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 Cherry Creek Ins. Agency, Inc. Suite 500 5660 Greenwood Plaza Blvd. Greenwood Village, CO 80111 CONTACT PHONE Annette Campbell FAX lac No Exr:303-799-0110 AIC No): 303-799-0156 E-MAIL ADDRESS: AnnotteC@thinkccig.com Joint Venture - Producers INSURE 8 AFFORDING COVERAGE NAIC e INSURER A: Homeland Ins. Co. of New York INSURED Colorado Hazardous INSURERS: Atlantic Casualty Ins Co Environmental, Inc. PO Box 8901 INSURER C : Pinnacol Assurance 41190 INSURER D : Denver, CO 80201 INSURER E : INSURER F : 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. MTR TYPE OF INSURANCE U POLICY NUMBER M ID Y EFF MM DDY EXP UMnS A X COMMERCIAL GENERAL LIABauTY CLAIMS -MADE a OCCUR X 7930031570000 03/12Y101S 05/01/2016 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Eeoewnence $ 50,00 MED EXP (Arty one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GEML AGGREGATE LIMIT APPLIES PER: POLICY1:1 JECT LOC GENERAL AGGREGATE $ 2,000,00 X PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY EOMBIBINEDISINGLE LIMIT $ 1,000,00 X BODILY INJURY (Per person) $ B ANY AUTO X 7930031580000 03M212015 03/12/2016 ALL OWNED SCHEDULED AUTOS AUTOS $ BODILY INJURY (Per accident) NON -OWNED HIRED AUTOS AUTOS(Per PReOPPEER, DAMAGE Pdon $ MBRELLALIAa X OCCUR EACH OCCURRENCE $ 5,000,00 4EXCESS AGGREGATE $ 5,000,00 q LIAR CLAIMS -MADE 7930031590000 03M2/2015 05MI2016 ED X RETENTIONS 10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUnVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N f A 163832 05/01/2016 05/01/2016 PER OTH- X STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT 6 1,000 ,00 A lPollutionLiab 7930031570000 103/12/2015 05/01/2016 Per Occur 1,000,00 A ',Professional Liab 7930031570000 Per Occur 1,0N,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As required by written contract or written agreement, City of Fort Collins is included as Additional Insured under General Liability and as Additional Insured under Automobile Liability. PJy �a1�Pl@ City of Fort Collins PO 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. AUTHORIZED REPRESENTATIVE pP © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD