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HomeMy WebLinkAbout121136 NORTHERN ENGINEERING SERVICES INC - INSURANCE CERTIFICATE (3)�..•� OP ID: TA ACORO DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03116/2016 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). CONTACT PRODUCER Phone: 970-223-1804 NAME: Front Range Insurance Group PHONE FAX 1100 Haxton Drive Suite 100 Fax: A/c No Ex1 : A/c No): Fort Collins, CO 80525 E-MAIL ADDRESS: David A. Wooldridge LUTCFAAI PRODUCER NORT-16 r`I ICTnMFR In *. INSURED Northern Engineering Services, Inc. Ketterling, Butherus 8r Norton Engineers 301 N Howes St, Ste 100 Fort Collins, CO 80521 INSURER(S) AFFORDING COVERAGE INSURER A: RLI Insurance Company INSURER B : Pinnacol Assurance INSURER C : INSURER D : r vinnArmo r`C0T1C1f'ATC ul IaaQeo• RFVi-glnN MIIMRFR- 190 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 A L, U POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS A A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR X Contractual Liab X PS60002740 01/15/2016 01/15/2017 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1 ,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PROJECT LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE X LIABILITY ANY AUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X PSA0001663 PSA0001663 PSA0001663 PSA0001663 01/15/2016 01/15/2016.01/15/2017 01/15/2016 01/15/2016 01/15/2017 01/15/2017 01/15/2017 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE (Per accident) X X Coll Deduct $ 1,00 Comp Deduct $ 1,00 A X UMBRELLA UAB EXCESS LIAB X OCCUR CLAIMS -MADE PSE0003116 01/15/2016 01/15/2017 EACH OCCURRENCE $ 4,000,00 AGGREGATE $ 4,000,00 DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 170568 01/01/2016 01/01/2017 X WC STATU OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYE_q $ 1,000,00 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,00 A Professional Liab RDP0023780 03/03/2016 03/03/2017 Per Claim 2,000,00 Aggregate 2,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is covered as additional insured under the genearal & auto liabilty policy. The insurance evidenced by this Certificate will not reduce coverage or limits and will not be cancelled, except after thirty (30) days written notice has been received by the City of Fort Collins. GLK I IFIGA I L HULULK l+A1V l.GLLA I IUIN CITYFC1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD