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HomeMy WebLinkAboutWESTERN ECOSYSTEMS TECHNOLOGY INC - INSURANCE CERTIFICATEClient#: 1251138 WESTEEC01 DATE (MM/DD'YYYY) ACORDT, CERTIFICATE OF LIABILITY INSURANCE 1 4/04/2016 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). PRODUCER CONTACT Karla Wright, CISR USI Insurance Services PHONE 307-635-4231 307-635-4237 1904 Warren Ave. E-MAIL � EXtZ- AC No): No ADDRESS: karla.wright@usi.biz Cheyenne, WY 82001 INSURER(S) AFFORDING COVERAGE NAIC# 307 635-4231 INSURER A, Hartford Casualty Insurance Com 29424 INSURED Western Ecosystems Technology, Inc. 415 W. 17th Street, Suite 200 Cheyenne, WY 82001 INSURER B : Markel American Insurance Compa INSURER c : Granite State Insurance Company INSURER D : Continental Casualty Company INSURER E : James River Insurance Company INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 12203 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 CONTRACTOR 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 IN R TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF POLICY EXP (MM/DD/YYYY) MM/DD/Y LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR X X 34UUNA09132 - 34UUNA09132 CA4360016302 2/03/2016 02/03/2017 2/03/2016 02/03/201 2/03/2016 02/03/2017 EACH OCCURRENCE $1 00000O $300 000 PREMISES (ERENTED occu ence) MED EXP (Any one person) _ $10 000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: n PRO _XJ POLICY I_. I JECT LOC OTHER: ---- AUTOMOBILE LIABILITY ANY AUTO X ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS I GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $2,000,000 --- ------ $ --- A E X X COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ $ PROPERTY DAMAGE Per accident CSL $1,000,000 B X UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE X X MKLM20LE105990 34UUNAQ9132 592376511 66183490 166183491 2/03/2016 02/03/2017 EACH OCCURRENCE_ $10,000 000 AGGREGATE $1 O 000,000 DED I X RETENTION $1 O 000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE[ Y / N OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 2/03/2016 4/02/2016 4/04/2016 4/04/2016 02/03/201 X I PER OTH- E.L. EACH ACCIDENT --— $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 D C C Professional Liab Worker's Comp I Worker's Comp X X _ 04/02/2017 $5,000,000/$5,000,000 04/04/2017! $1,000,000 04/04/2017 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This Certificate is issued for insured operations usual to Environmental & Natural Resources Consultants. The General Liability, and Auto Liability policies include an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder, only when there is a written contract or (See Attached Descriptions) City of Fort Collins 700 Wood Street Fort Collins, CO 80521 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 C ACORD 25 (2014/01) 1 of 2 #S17596220/M17585683 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KXVZP DESCRIPTIONS (Continued from Page 1) written agreement between the named insured and the certificate holder and with regard to work performed on behalf of the named insured. The General Liability, Auto Liability and Worker's Compensation policies provide a Blanket Waiver of Subrogation in favor of the same, when required by written contract. The General Liability and Auto Liability policies contain a special endorsement with "Primary and Noncontributory" wording, when required by written contract. POLICY TYPE: Auto Liability CARRIER: James River Insurance Company POLICY TERM: 02/03/2016 02/03/2017 POLICY NUMBER: CA4360016302 Hired and Non -Owned Auto POLICY TYPE: Workers Compensation All States Except WY, ND, WA, OH & CA CARRIER: Granite States Insurance Co. POLICY TERM: 04/04/2016 - 04/04/2017 POLICY NUMBER: 66183490 Statutory $1,000,000 Each Accident $1,000,000 Disease Policy Limit $1,000,000 Disease Each Employee POLICY TYPE: Workers Compensation - CA CARRIER: Granite States Insurance Co. POLICY TERM: 04/04/2016 - 04/04/2017 POLICY NUMBER: 66183491 Statutory $1,000,000 Each Accident $1,000,000 Disease Policy Limit $1,000,000 Disease Each Employee POLICY TYPE: Stop Gap/EL CARRIER: Hartford Casualty Insurance Company POLICY TERM: 02/03/2016 02/03/2017 POLICY NUMBER: 34UUNAQ9132 WY, ND, WA & OH Stop Gap Liability $1,000,000 - Each Employee $1,000,000 - Each Occurrence $1,000,000 - Aggregate Western EcoSystems Technology Inc. has used or sometimes referenced the dba WEST Inc. This is only an acronym used, not an official dba or entity name. SAGITTA 25.3 (2014/01) 2 of 2 #S17596220/M17585683 Client#: 1251138 WESTEEC01 ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 1/27/2016 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). PRODUCER USI Insurance Services 1904 Warren Ave. Cheyenne, WY 82001 307 635-4231 CONTACT Karla Wright, CISR HEN E. E>n 307-637-2525 FAX ac, Noll: 307-635-4237 EMAIL ADDRESS: karla.wright@usi.biz INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Hartford Casualty Insurance Com 29424 INSURED Western Ecosystems Technology, Inc. 415 Street, Suite 200 Cheyyeennnee,, WY 82001 INSURER B : Markel American Insurance Compa 28932 INSURER C: Continental Casualty Company 20443 C& Indt Insurance C INSURER D: Commerce Industry 19410 INSURER E: James River Insurance Company 112203 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 CONTRACTOR 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 INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X X 34UUNA09132 2/03/2016i 203/201 EACH $1,000,000 CLAIMS -MADE a OCCUR �OCCURRENCE PREMISES Ea occurrence $300 000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PR XI POLICY jjJECOT I LOC GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ OTHER: _ A _ _ _ AUTOMOBILE LIABILITY X X 34UUNA09132 2/03/2016 02/03/201 (Ea aBciden SINGLE LIMIT 1,000,000 BODILY INJURY (Per person) $ ANY AUTO X ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ CSL EACH OCCURRENCE $1,000,000 $1 O 000,000 E XHired Autos X Non -Owned Aut I CA4360016302 2/03/2016 02/03/2017 UMBRELLA LIAB X OCCUR AGGREGATE $1 O 000 000 B X EXCESS LIAR_ CLAIMS -MADE X X MKLM20LE1059 2/03/2016 02/03/201 DED X. RETENTION$10000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) N/A X 34UUNAQ9132 2/03/2016 02/03/201 PER OTH- X T" E.L. EACH ACCIDENT_ $1 000 000 E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below 4/02/2015 04/02/2016 E.L. DISEASE - POLICY LIMIT $1,000,000 $5,000,000/$5,000,000 C Professional 592376511 D workers comp X 062716092 4/04/2015 04/04/201 $1,000,000 D Workers Comp -CA X 62716093 4/04/2015 04/04/2016 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101. Additional Remarks Schedule, may be attached if more space is required) This Certificate is issued for insured operations usual to Environmental & Natural Resources Consultants. The General Liability, and Auto Liability policies include an automatic Additional Insured endorsement that provides Additional Insured status to the Certificate Holder, only when there is a written contract or written agreement between the named insured and the certificate holder and with regard to work performed on (See Attached Descriptions) City of Fort Collins 700 Wood Street Fort Collins, CO 80521 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 \C ACORD 25 (2014/01) 1 Of 2 #S17143336/M17123900 ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD KDMZP DESCRIPTIONS (Continued from Page 1) behalf of the named insured. The General Liability, Auto Liability and Worker's Compensation policies provide a Blanket Waiver of Subrogation in favor of the same, when required by written contract. The General Liability and Auto Liability policies contain a special endorsement with "Primary and Noncontributory" wording, when required by written contract. POLICY TYPE: Auto Liability CARRIER: James River Insurance Company POLICY TERM: 02/03/2016 02/03/2017 POLICY NUMBER: CA4360016302 Hired and Non -Owned Auto POLICY TYPE: Workers Compensation All States Except WY, ND, WA, OH & CA CARRIER: Commerce & Industry Insurance Co POLICY TERM: 04/04/2015 04/04/2016 POLICY NUMBER: 62716092 Statutory $1,000,000 Each Accident $1,000,000 Disease Policy Limit $1,000,000 Disease Each Employee POLICY TYPE: Workers Compensation - CA CARRIER: Commerce & Industry Insurance Co. POLICY TERM: 04/04/2015 04/04/2016 POLICY NUMBER: 62716093 Statutory $1,000,000 Each Accident $1,000,000 Disease Policy Limit $1,000,000 Disease Each Employee POLICY TYPE: Stop Gap/EL CARRIER: Hartford Casualty Insurance Company POLICY TERM: 02/03/2016 02/03/2017 POLICY NUMBER: 34UUNA09132 WY, ND, WA & OH Stop Gap Liability $1,000,000 - Ea Employee $1,000,000 - Ea Occurrence $1,000,000 - Aggregate Western EcoSystems Technology Inc. has used or sometimes referenced the dba WEST Inc. This is only an acronym used, not an official dba or entity name. SAGITTA 25.3 (2014/01) 2 of 2 #S17143336/M17123900