HomeMy WebLinkAboutTHE WESTERVELT CO - INSURANCE CERTIFICATECertificate of Insurance
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON YOU THE CERTIFICATE HOLDER. THIS CERTIFICATE IS NOT AN
INSURANCE POLICY AND DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW, POLICY LIMITS ARE NO LESS THAN THOSE
LISTED, ALTHOUGH POLICIES MAY INCLUDE ADDITIONAL SUBLIMIT/LIMITS NOT LISTED BELOW.
This is to Certify that
I The Westervelt Company
& as per Named Insured Endorsement 1 NAME AND
PO Box 48999 ADDRESS
Tuscaloosa AL 35404-8999 II OF INSURED
L J
Lip b er MUtUA.
INSURANCE
is, at the issue date of this certificate, insured by the Company under the policy(ies) listed below. The insurance afforded by the listed policy(ies) is subject to all their terms, exclusions and
Conditions and is not altered by any requirement, term or condition of any contract or other document with respect to which this certificate may be issued.
EXP DATE
TYPE OF POLICY
❑ CONTINUOUS
❑ EXTENDED
POLICY NUMBER
LIMIT OF LIABILITY
2 POLICY TERM
WORKERS
COMPENSATION
6/30/2020
WA7-65D-434151-239
COVERAGE AFFORDED UNDER WC
LAW OF THE FOLLOWING STATES:
ND39: All States Except: OH, WA,
EMPLOYERS LIABILITY
Bodily Inju by Accident
500 000 Each Accident
Bodily Injury By Disease
500 ODU
WA7-65 D-434151-259
-259: CA
i=mployers Liability: $1,000,000
Bodily Injury By Disease
500 000 E h P r
COMMERCIAL
GENERAL LIABILITY
6/30/2020
TB2-651-434151-029
Gcneral Aggregate
$2,000,000
Products / Completed Operations Aggregate
2 OCCURRENCE
ElCLAIMS MADE
$2,000,000
Each Occurrence
$1 000 000
Personal & Advertising Injury
$1 000 000 Per Person /Organization
RETRO DATE
Other The'
Damage to premises rented toedical
ou: 50 0
Expense:
5 000
AUTOMOBILE
LIABILITY
6/30/2020
AS2-651-434151-039
Each Accident —Single Limit
$2,000,000 B.I. And P.D. Combined
Z OWNED
Each Person
Each Accident or Occurrence
ZNON -OWNED
ZHIRED
Each Accident or Occurrence
OTHER
ADDITIONAL COMMENTS
The City of Fort Collins is included as additionally insured with respect to General Liability and Auto Liability as required by written contract
* If the certificate expiration date is continuous or extended tern, you will be notified if coverage is terminated or reduced before the certificate expiration date.
NOTICE OF CANCELLATION: (NOT APPLICABLE UNLESS A NUMBER OF DAYS IS ENTERED BELOW.)
BEFORE THE STATED EXPIRATION DATE THE COMPANY WILL NOT CANCEL OR REDUCE THE
INSURANCE AFFORDED UNDER THE ABOVE POLICIES UNTIL AT LEAST 30 DAYS NOTICE
OF SUCH CANCELLATION HAS BEEN MAILED TO:
City of Fort Collins
PO BOX 580
Fort Collins CO 80522
d=
v
R
Liberty Mutual
Insurance Group
Tammy Scipio
AUTHORIZED REPRESENTATIVE
Lawrenceville / 0505
2530 Sever Road, Suite 200
Lawrenceville GA 30043-4024 770-814-9002 6/28/2019
OFFICE
PHONE DATE ISSUED
This certificate is executed by LIBERTY MUTUAL INSURANCE GROUP as respects such insurance as is afforded by those Companies NM 772 07-10
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