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468473 VEOLIA ES TECHNICAL SOLUTIONS LLC - INSURANCE CERTIFICATE (8)
AC7" CERTIFICATE OF LIABILITY INSURANCE DATE /9120M18 D/YYYY) 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 Marsh USA, Inc. NAME: 540 W. Madison Street PHONENo Ex _FAX No: Chicago. IL 60661 E-MAADDRESS: Attn: Veolia.CertRequest@marsh.com I Fax. 212-948-5053 --- -- - - — - INSURER(S)AFFORDING COVERAGE _ NAIC# HEN-TS INSURER A : National Union Fire Insurance Company Of Pittsburah. 119445 INSURED Veolia ES Technical Solutions, LLC 9131 East 96th Avenue Henderson. CO 80640 c : WA IND I INSURER E : Illinois National Insurance Comoanv 123817 1 COVERAGES CFRTIFICATF Nl1MRFR- CHI-008065640-52 RFVISIr)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. INSR ADDL SUBR - - - - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE &5k WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ix OCCUR GL542-5835 01/01/2019 01/01/2020 EACH OCCURRENCE $ 1,000,000 DAMAGERENTED PREMISES Ea occurrence $ 1,000.000 MED EXP (Any one person) $ 10,000 _ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. X POLICY PRO JECT LOC GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP/OP AGG $ 1,0X000 $ OTHER A A AUTOMOBILE LIABILITY ANY AUTO CA 976-74-18 (AOS) CA 976-74-19 (MA) 01101/2019 01101/2019 01101/2020 01101/2020 COMBINED SINGLE LIMIT (Ea accident. $ 1,000,000 X BODILY INJURY (Per person) $ A OWNED - SCHEDULED AUTOS ONLY AUTOS CA 976-74-20 (VA) 01/01/2019 0110112020 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident _ $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE $ DED I RETENTION $ B B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) N/A WC 046-91-2802 (AOS) WC 046-91-2803 AZ,IL,KY,NC,NH,NJ, ( PA,UT,VA.VT) 01/01/2019 01/01/2020 01/0112020 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E1 DISEASE - EA EMPLOYEE $ 1,000,000 E If yes describe under DESCRIPTION OF OPERATIONS below WC 046-91-2804 (FL) 01/01/2019 01/01/2020 E.L. DISEASE - POLICY LIMIT $ 1,000,000 D Pollution Legal Liability W1D4C8190301 01/01/2019 01/0112020 Per Claim 1,000,000 Claims Made Form SIR $750,000 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, its officers, agents and employees are included as additional insured where required by written contract but only for liability arising out of the operations of the named insured with respect to General Liability and Auto Liability CtK I IFICA I t HOLUtK CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Purchasing Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn Ed Bonnette, CPM ACCORDANCE WITH THE POLICY PROVISIONS. 215 North Mason P.O Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. ManashiMukherjee _ttacuoc,►� .��Q�tec..,..<c © 1988.2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD