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HomeMy WebLinkAbout110168 U S ENGINEERING CO - INSURANCE CERTIFICATE (12)ACORb' CERTIFICATE OF LIABILITY INSURANCE 7/31/2016 DATE(MM/DD/YYYY) 7/24/2015 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 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 L;QCT NAMEHONE 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 FAX A/C, No, Ext : A/C, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Insurance Company 23043 INSURED U.S. ENGINEERING COMPANY INSURER B : St. Paul Fire and Marine Insurance Company 24767 1354733 3433 ROANOKE KANSAS CITY MO 64111 INSURER C INSURER D : INSURER E : INSURER F : COVERAGES* CERTIFICATE NUMBER: 1 1886393 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/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR N N TB5-Z91-457358-015 7/31/2015 7/31/2016 EACH OCCURRENCE 2,000 000 PREM SESGE � a oNcurrDence 300,000 MED EXP (Any oneperson)10 000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE� LOC OTHER GENERAL AGGREGATE $ 4,000 000 PRODUCTS - COMP/OP AGG $ 4,000 000 $ A AUTOMOBILE LIABILITY ANY AUTO AUTOWNED SCHEDULED NON -OWNED HIRED AUTOS AUTOS N N AS2-Z91-457358-035 7/31/2015 7/31/2016 EOa aocldeDtSINGLE LIMIT $ 1,000, 000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE Per accident $XXXXXXX Comp/Coll Deds. $ 2,000 f3 UMBRELLA LIAB EXCESS LIAB CLAIMS -MADE N N ZUP-31 M37065-15-NF 7/31/2015 7/31/2016 EACH OCCURRENCE $ 5,000,000 X NOCCUR AGGREGATE $ 5,000,000 DED I I RETENTION $ $ XXXXXXX A WORKERS COMPENSATION AND EMPLOYERS' LIABILIITY Y/N ANY OFFICER/MEMBER PROPRIETOR/PARTNER/EXECUTIVE FN,N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / A N WA2-Z9D-457358-025 7/31/2015 7/31/2016 POTH- X STATUTE FIR 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 I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) All operations conducted by the insured. 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. 11886393 I AUTHORIZED REPRESENTATIVE City of Fort Collins P 0 Box 580 Fort Collins CO 80522 ACORD 25 (2014/011 n 1 88-2014 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD