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HomeMy WebLinkAbout102630 AYRES ASSOCIATES INC - INSURANCE CERTIFICATE (5)DATE (MM/DD/YYYY) ACORCI® CERTIFICATE OF LIABILITY INSURANCE 12/18/2018 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 CONTACT NAME:_ Sharon Bannach _ Arthur J. Gallagher Risk Management Services, Inc. PHONE 262-792-2214 F4X No): 262 792 1712 245 South Executive Drive, Suite 200 E-MAIL Brookfield WI 53005 ADDRESS: Sharon Bannach(Maicl.com INSURED AYRES ASSOCIATES INC 3433 Oakwood Hills Parkway Eau Claire, VVl 54702-1509 AYREASS-02 INSURER(S) AFFORDING COVERAGE NAIC 1f INSURER A Travelers Property Casualty Co of America 25674 INSURER B : The Travelers Indemnity Company of CT 25682 COVFROGFR CFRTIFICOTF NIIMRFR•44g3dA'1R7 RFVIRIr)N NIIMRFR- 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. A66CTS0181_POLICY EFF POLICY EXP TR TYPE OF INSURANCE POLICY NUMBER i MMlDDlYYYY !DDlYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y P6302183P260TIA19 1/1/2019 1/1/2020 EACH OCCURRENCE $1,OD0,000 CLAIMS -MADE L _K OCCUR VAae Tb gt=i�iET1 _ ..___ PRIMIS� .fE Qc 4[rv..ara) $ 300 000 A` -- - _ — MED EXP (Any oneperson) $10 000 _..... PERSONAL 8 ADV INJURY $ 1 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: l _X POLICY %( u LOC JE ° GENERAL AGGREGATE �PRODUCTS_COMP/OP AGG $ 2,000,000 ------ _$2,000,000 OTHER: $ A AUTOMOBILE LIABILITY Y 81021-352245 1 1/1/2019 1/1/2020 COMBINED SINGLE LIMIT CEO accid-4qt) - $1,000,000 ----- X ANY AUTO BODILY INJURY (Per person) $ OWNED I SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED X AUTOS ONLY x I AUTOS ONLDY OPEcRdT�nuAMAtiE tNR $ $ A X UMBRELLALIAB X OCCUR CUP9J784097 1/1/2019 1/1/2020 EACH OCCURRENCE -- --- - $8,000,DD0 $ 8,000,0W EXCESS LIAB CLAIMS -MADE AGGREGATE Products/Compl Ops DED 7 RETENTION $ n i $ 8,000,000 g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE F7NI OFFICERMEMBER EXCLUC N I A UB9H9437751843E 1/1/2019 1/1/2020 X PER OTH- i STATI:JTE -- I ER E.L. EACH ACCIDENT $1,000,D00 (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes.describe under DESCRIPTION OF OPERATIONS below .---_._._....___._._.._.___.... _.._.. _.._..._..._.. E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) RE: 8073 Engineering Services for Water, Wastewater & Stormwater Facilities Capital Improvements, The City of Fort Collins is named as Additional Insured on the General Liability policy per from CIS D2 47 08 05 and Auto Liability as per form CAT3 53 0310. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City of Fort Collins 215 N. Mason Street Fort Collins CO 80524 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2 of 2 15010