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HomeMy WebLinkAbout468473 VEOLIA ES TECHNICAL SOLUTIONS LLC - INSURANCE CERTIFICATE (11)ACC>R" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/08/2015 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 Marsh USA, Inc. 540 W. Madison Street CONTACT NAME: PHONE FAX /c A/c No): E-MAIL ADDRESS: Chicago, IL 60661 Attn: Veolia.CertRequest@marsh.com I Fax: 212-948-5053 INSURERS AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 HEN-TS INSURED Veolia ES Technical Solutions, LlC 9131 East 96th Avenue INSURER B : ACE Fire Underwriters Insurance Company 20702 INSURER C : NIA N/A INSURER D : Henderson, CO 80640 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-00521884040 REVISION NUMBER:8 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 OF INSURANCE ADDLITYPE INgQ SUER POLICY NUMBER EFF MM/DD/YYYY IDDPOLICY EXP POLICY /YYYY MM LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE M OCCUR HDO G27402884 01/01/2016 01/01/2017 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO ❑ LOC X JECT OTHER GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS ISA H0386651A 01/01/2016 01/01/2017 COAARINFn SINGLE I ]MIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN rNJ D? OFFICER/MEMBER EXCLUDE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WLR C48598158 (AOS) SCF C48598195 (WI) (Retro) 01/01/2016 01/01/2016 01/01/2017 01101/2017 H X STATUTE EOR 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 (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, its officers, agents and employees are included as additional insured (except as respects all coverage afforded by workers' compensation) where required by written contract but only for liability arising out of the operations of the named insured, CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Purchasing Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Ed Bonnette, CPM ACCORDANCE WITH THE POLICY PROVISIONS. 215 North Mason P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjeea+tivra 4,.tc..unu © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD l ® ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/08/2015 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 Marsh USA, Inc. 540 W. Madison Street CONTACT NAME: PHONE FAX A/ t • A/c No): E-MAIL ADDRESS: Chicago, IL 60661 Attn: Veolia.CertRequest@marsh.com I Fax: 212-948-5053 INSURERS AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 LOM- _ INSURED Veolia ES Technical Solutions, LLC 700 East Butterfield Road, Suite 201 INSURER B : Illinois Union Insurance Company 27960 INSURER C : NIA N/A INSURER D : ACE Fire Underwriters Insurance Company 20702 Lombard, IL 60148 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-005475740-30 REVISION NUMBER:5 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 OF INSURANCE ADDLTYPE INSD SUER POLICY NUMBER ICY EFF DD/YYYY) MML POLICY EXP (MM/DD/YYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY HDO G27402884 01/01/2016 01/01/2017 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE PREM SESOEa TED oNcu enc. $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 1,000,000 POLICY PRO ❑ LOC X JECT PRODUCTS - COMP/OP AGG $ 1,000,000 $ OTHER. A AUTOMOBILE LIABILITY ISA H0886651A 01/01/2016 01/O?12Q17 COMBINED SINGLE LIMIT Ea accident ?,OM,GGO BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOAUUTOSTOS NON -OWNED S N PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A WLR C48598158 (ADS) �) ( ) SCF C48598195 I Retro 01/0112016 01/01/2016 01/01/2017 01/01/2017 X PER or H- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below B Prof Liability/Claims-Made GOO G27269096002 01/01/2016 01/01/2017 Limit 1,000,000 Contractors' Poll Occurrence CPL SIR: $500,000 Prof Liab SIR: $1,000,000 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as additional insured (except as respects all coverage afforded by workers' compensation and professional liability) where required by written contract but only for liability arising out of the operations of the named insured. A waiver of subrogation is granted as required by written contract but only for liability arising out of the operations of the named insured. CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P.O. Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. ManashiMukherjee @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD