HomeMy WebLinkAboutMORROW HOLDINGS LLC DBA RISK REMOVAL - INSURANCE CERTIFICATE (4)Iq
A� o® CERTIFICATE OF LIABILITY INSURANCE
DDrYYY
DATE(04/2019Y)
10/04/2019
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
CONTACT NAME: Karen O'CONNELL
P"C"E 708-598-5355 F�ACC No, 708-598-6686
Bonding &Insurance Specialists Agency, Inc.
ADDRESS: koconnell@bisa-inc.com
In California, DBA Bonds and Insurance Services, Lic. #0795489
INSURERS AFFORDING COVERAGE
NAIC#
13841 Southwest Highway
INSURERA: Starr Surplus Lines Insurance Company
13604
Orland Park IL 60462-1354
INSURED
INSURER B: American Interstate Insurance Company
24759
INSURERC:
Morrow Holdings, LLC D/B/A Risk Removal
6250 Iron Forge Road
INSURER D:
INSURER E :
Timnath CO 80547
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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.
I
LTDWYY
LTR
TYPE OF INSURANCE
INSD
SUERPOLICY WVD
POLICYNUMBER
MM Y
MM nnrYYYY
LIMITS
A
X
COMMERCWLGENERALUABIUTY
Y
Y
EACH OCCURRENCE
$ 1,000,000
CLAIM&MADE OCCUR
1000067137191
10/01/19
10/01/20
PREMISES Ea occurrence
$ 100,000
X
MED EXP(Any one person)
$ 5,000
`Contractors Pollution Liability
X
Includes Asbestos & Lead
PERSONAL&ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY PEA LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
'PER CLAIM
$ 1,000,000
OTHER.
B
I AUTOMOBILE LIABILITY
X ANY AUTO
Y
Y
1000626154191
10/01/19
10/01/20
COMBINED SINGLE LIMIT
Be accident
$ 1,000,000
BODILY INJURY (Per person)
$
OWNEDONLY AUTOS SCHEDULED
AUTOS
HIRED NON -OWNED
X AUTOS ONLY X AUTOS ONLY
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
$
A
X
UMBRELLALIAB
X
OCCUR
Y
Y
1000337430191
10/01/19
10/01/20
EACH OCCURRENCE
$ 2,000,000
EXCESS LIAB
CLAIMS -MADE
CGL (Incl. CPL/PL/Mold),
Auto & Employers Liability
AGGREGATE
$ 2,000,000
DIED I I RETENTION$
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
OFFICE (MEMBR/PARTNER/EXECUTIVE YIN
in N REXCLUDED9 ❑Y
(Mandatory in NH)
(Mandatory
N/A
Y
AVW CCO2836632019
10/01/19
10/01 /20
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMiT
$ 1,DDD,000
A
MOLD OPS- OCCURREN OCCURRENCE
Y
Y
1000067137191
10/01/1
10/01/2
$1,000,000-MOLD AGGREGATE
PROFESSIONAL LIABILITY- CLAIMS MADE FORM
S1,M0,000 - PER CLAIM
$2,000,000 - AGGREGATE
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
RE: WATER UTILITIES, 700 WOOD STREET, FORT COLLINS, CO
AS REQUIRED BY WRITTEN CONTRACT OR WRITTEN AGREEMENT, THE CERTIFICATE HOLDER IS
INCLUDED AS ADDITIONAL INSURED FOR ONGOING OPERRATIONS UNDER GENERAL LIABILITY
WITH RESPECT TO THE ABOVE REFERENCED.
CERTIFICATE HOI nFR CANCELLATION
CITY OF FORT COLLINS
ATTN: PURCHASING
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
P.O. BOX 580
ACCORDANCE WITH THE POLICY PROVISIONS.
FORT COLLINS, CO 80522-0580
KAO
AUTHORIZED REPRESENTATIVE
I XD", M -`�
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