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HomeMy WebLinkAbout486984 LAYNE INLINER LLC - INSURANCE CERTIFICATE (8)P32611028e2 DATE(MM/DDIYYYY) AC40RV CERTIFICATE OF LIABILITY INSURANCE 09/19/2018 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 have ADDITIONAL INSURED provisions or 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 LIC #OC36861 1-415-403-1491 CONTACT Kimberly m NAME: Y Leika Alliant Insurance Services, Inc. -PHONE ANC No Erth 415-403-1491 _ pog 415-874-4818 E-MAIL kleikaMOalliant.com 100 Pine Street, llth Floor ADDRESS: INSURER(S) AFFORDING COVERAGE HMS San Francisco, CA 94111 INSURER A: VALLEY FORGE INS CO 20508 INSURED INSURER B: CONTINENTAL CAS CO 20443 Layne Inliner, LLC TRANSPORTATION INS CO 20494 Granite Inliner, LLC INSURERC: 585 West Beach Street INSURERD: INSURER E Watsonville, CA 95076 INSURER F: rnVFoer_cc rFRTIFIrATF MiIURFR• 5d005307 RFVlginM tJIIURFR- 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 ADDL SUBR POLICY EFF POLICY EXP LWfTs LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY M OD A x COMMERCIAL GENERAL LIABILITY X GL2074978689 10/01/18 10/01/21 EACH OCCURRENCE f 2.000,000 —-DA—MAGET-0 CLAIMS -MADE (x l OCCUR RENTED_ PREMISES Ea occurrence f 2,000,000 MED EXP (Any one person) $ Nil -- --- - PERSONAL d ADV INJURY i 2,000,000 GENERAL AGGREGATE $ 10, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PET [�] LOC PRODUCTS -COMPIOPAGG i 2,000,000 f OTHER: A AUTOMOBILE LIABILITY _ x BUJL2074978692 10/01/18 10/01/21 COMBINED SINGLE LIMIT e accident $ 2,000,000 _ BODILY INJURY (Per person) f X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS x HIRED x NON -OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Par accldarll) f PROPERTYDAMAGE Per accident $ E B X UMBRELLA LIAB x OCCUR CUR2068209453 10/01/18 10/01/19 EA CH_ OCCURRENCE $ 8.000,000 AGGREGATE f 8,000,000 X EXCESS LIAR CLAIMS -MADE _ _ DEU RETENTION $ : A C A WORKERS COMPENSATION AND EMPLOYER$' LIABILITY YIN ANYPROPRIETORIPARTNERIEXECUTIVE � OFFICER/MEMBEREXCLUDED7 (Mandatory In NH) NIA WC274978644 (AOS/StopGap WC274978658 (NY) WC274978630 (CA) 10/01/18 10/01/18 10/01/18 10/01/19 10/01/19 10/Ol/19 x PE TUTS I I OETH E.L. EACH ACCIDENT :2.000,000 E.L. DISEASE -EA EMPLOY : 2.000,000 C Dyes describe under DESCRIPTION OF OPERATIONS belowWC274978661 (NT,WI,HI) 10/01/18 10/01/19 E.L. DISEASE -POLICY LIMIT f 2,000.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space Is required) Certificate holder is included as an Additional Insured on the General Liability and Automobile Liability policies as required by written contract subject to policy terms, conditions and exclusions. ULK11FICAlt 11ULULK OF FORT COLLINS, COLORADO LAPORTE AVE. COLLINS, CO 80522 ACORD 25 (2016103) lmadarasz 54005307 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 USA ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD rn 00 00 z W