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Home My WebLink About486984 LAYNE INLINER LLC - INSURANCE CERTIFICATE (11)ACORN` CERTIFICATE OF LIABILITY INSURANCE 8/1/2016 F DATE(MM/DD/YYYY) 1 7/28/2015 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 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 CONTACT NAME: -RUNE FA wc, No, EXt : A/c, No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Zurich American Insurance Company 16535 INSURED LAYNE INLINER, LLC 1376181 1775 EAST 69TH AVENUE DENVER CO 80229 INSURER B : American Zurich Insurance Company 40142 INSURER C : Lexington Insurance Company 19437 INSURER D : American Guarantee and Liab. Ins. Co. 26247 INSURER E : INSURER F : COVERAGES LAYIN01 CERTIFICATE NUMBER: 107MO04 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 Y N GLO 5817438-02 W1,12015 8/1/2016 EACH OCCURRENCE $ 2,000,000 CLAIMS -MADE � OCCUR PREM PREMISES (Ea occGE TO urrence) 500,000 X' MED EXP (Any oneperson) 10,000 CONTRACTUAL X X.C.0 COVERAGE PERSONAL & ADV INJURY $ 2,000 000 GEN'LAGGREGATE LIMIT APPLIES PER : }� POLICY ❑ JECOT- ❑ LOC GENERAL AGGREGATE $ 5000000 PRODUCTS - COMP/OP AGG $ 5,000,000 $ OTHER A AUTOMOBILE LIABILITY N N BAP 5817437-02 8/l/2015 8/1/2016 COMBINED SINGLE LIMIT Ea accident $ 5 000 000 X BODILY INJURY (Per person) $ X'X'XXXX'X' ANY AUTO ALLOWNED !SCHEDULED BODILY INJURY (Per accident $XXXXXXX HIRED AUTOS AUTOS NED PROPERTY accidentDAMAGE $ XXXXXXX $ XXXXXXX D X UMBRELLA LIAB 1 X OCCUR N N AUC 3807886-1 1 8/1/2015 8/ 1'2016 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ XXXXXXX B AANYPROPRIETOR/ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N OFFICERlMEMBER EXCLUDED?ECUTIVE FN (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A N WC 5817439-03 AOS) WC 5817440-03 (WI) STOPGAP(ND,O ,WA,WY) 8/1/2015 8/1/2015 8/1/2015 8/1/2016 8/1/2016 8/1/2016 PER OTH- X STATUTE EL EACH ACCIDENT $ 5,000,000 E.L. DISEASE - EA EMPLOYEE 5,000,000 E.L. DISEASE - POLICY LIMIT Is5,000,000 C EQUIPMENT FLOATER N N 026159794 8/l/2015 8/1/2016 ALL LEASF,D, OWNED OR RENTED EQUIPMENT. $5,000,000 LIMIT PER OCCURRENCE. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CITY OF FORT COLLINS, COLORADO IS AN ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY COVERAGE, ONLY AS REQUIRED BY CONTRACT, SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. CERTIFICATE HOLDER CANCELLATION 10726004 CITY OF FORT COLLINS, COLORADO 4316 LAPORTE AVE. FORT COLLINS CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/011 n 1 R-2014 ACORn CORPORATION All rinhts rpsprvprf The ACORD name and logo are registered marks of ACORD