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HomeMy WebLinkAboutCONTAMINATION CONTROL AND CERTIFICATION HOLDINGS I - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE 6/15/2020 DATE(MM/DD/YYYY) 1 6/11/2019 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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 NAMEHo E FAX A/C, NO, Ext : A/c, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Starr Surplus Lines Insurance Company 13604 INSURED CONTAMINATION CONTROL AND CERTIFICATION 1455554 HOLDINGS, INC TECHNICAL SAFETY SERVICES LLC INSURER B : Starr Indemnity & Liability Company 38318 INSURER C INSURER D : 620 HEARST AVE INSURER E : BERKELEY CA 94710 INSURER F : COVERAGES"" CERTIFICATE NUMBER: 15727707 REVISION NUMBER: XXXXXXX 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 INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP (MM/DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR N N 1000065716191 6d 5/2019 6/15/2020 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea ocE TO currrence 50,000 MED EXP (Any oneperson)5,000 PERSONAL & ADV INJURY $ 1,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO AAUTOS ONLY ED SCHEDULED HIRED NON -OWNED AUTOS ONLY AUTOS ONLY N N 1000626126191 6/15/2019 6/15/2020 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XX'XY,,_XXX' PROPERTY DAMAGE Per accident $XXXXXXX $XXXXXXX A UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N 1000336580191 6/15/2019 6/15/2020 EACH OCCURRENCE $ 10,000,000 X AGGREGATE $ 10,000,000 DED RETENTION $0 $ XXXXXXX 13 COMPENSATION WORKERS AND EMPLOYS' LIABILITY Y / N OFFICER/MEMBER EXCLUDED? ANY PROPRIETOR/PARTNER/EXECUTIVE N❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N 1000003266-01 6/15/2019 6/15/2020 X STATUTE OER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 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) 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. 15727707 City of Fort Collins PO BOX 580 Fort Collins CO 80522 F ele 7w*if,T171[:i I O 5 ACORD CORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD