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HomeMy WebLinkAbout551459 LT ENVIRONMENTAL INC - INSURANCE CERTIFICATE (4)�pszwa2wwz DATE (MM/DDIYYYY) " ACORU CERTIFICATE OF LIABILITY INSURANCE 06/27/2017 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 cerlI ffcate holder in lieu of such endorsement(s). PRODUCER 1-303-534-4567 CONTACT N_A_ME:____ IMA, Inc. - Colorado Division PHONE FAX 1705 17th Street Suite 100 Denver, CO 80202 INSURED LT Environmental, Inc. 4600 Hest 60th Ave. Arvada, CO 80003 ADDRESS:.__ denaccounttechs@imacorp.com INSURER(S) AFFORDING COVERAGE NAIC • 21199 _ INSURER A: ARCH SPECIALTY INS CO INSURER8: TRAVELERS PROP CAS CO OF AMER. 25674 INSURER C : ZURICH AMER INS CO(Pinnacol) 16535 INSURERD: PINNACOL ASSUR 41190 INSURER E : INSURER F: rn11C0Ar CC rFRTICIrATF MI IIMRF:R• 5n1 R7g45 RFVISION NIIMRFR- 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 ADDL SUER POLICY EFF POLICY EXP LIMBS LTR TYPE OF INSURANCE POLICY NUMBER MMMD MM/DD/YYYY A X COMMERCIAL GENERAL UABJ ITY 12EKP4345212 07/01/17 07/01/18 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE I _X J OCCUR DAMAGE TO RENTED PREMISES Ea oxurrence $ 100,000 X MED EXP (Anyone person) $ 5,000 BI Ded: $10, 000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 — POLICY PRO- JECT D LOC $ OTHER: B AUTOMOBILE LIABILITY DT8103A906345TIL17 07/01/17 07/01/18 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) _ $ l X I ANY AUTO ALL OWNED - SCHEDULED AUTOS AUTOS F--NON-OWNED X_ HIRED AUTOS R_ AUTOS BODILY INJURY (Per accident) $ _ PROPERTY DAMAGE (Per accident) : f A X UMBRELLA LIAB 8 OCCUR 12EMX4381710 07/01/17 07/01/18 EACHOCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS UAB CLAIMS -MADE DED J RETENTION $ $ C D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? N❑ (Mandatory in NH) N 1 A WC463252007 - 03 4023969 - CO 07/01/17 07/01/17 07/01/18 07/01/18 X STATUTE ERH 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 OPERA TONS below A lContractoris Pollution & 12EMP4345212 107/01/17 07/01/18 Limit $1'000,000 Professional Liability Pollution Ded. $10,000 Professional Ded. $25,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) City of Fort Collins is included as Additional Insured on the General and Automobile Liability Policies if required by written contract or agreement subject to the policy terms and conditions. The umbrella policy is excess of the general, pollution, professional liability, automobile liability and employers liability policies. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ty of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215 N. Mason Street, 2nd Floor AUTHORIZED REPRESENTATIVE PO Box 580 Fort Collins, CO 80522 USA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD francine 50187945 ri 0 P526002RW2 SUPPLEMENT TO CERTIFICATE OF INSURANCE DATE 06/2//2017 NAME OF INSURED: IT Environmental, Inc. Additional Description of Operations/Remarks from Page 1: Additional Information: Fungus/Spore/Mold Liability Coverage: Policy #12EMP4345212 Eff Date: 07/01/17-07/01/18 Insurer A: See Above $1,000,000 Per Claim Limit; $2,000,000 Aggregate Limit $10,000 Deductible Leased & Rented Equipment Coverage: Policy #QT6604H598789TIL17 Eff Data: 07/01/17-07/01/18 Insurer B: See Above $75,000 Limit; $1,000 Deductible SUPP (05/04) NS tl lll!HIII! x L.T. Environmental., Inc. Policy #12EMP4345212 Effective 07/01 /2017 - 07/01 /2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT COVERAGES A & B (ONGOING OPERATIONS ONLY) This endorsement modifies insurance provided under the Environmental Multiline Policy In consideration of the premium charged, it is hereby agreed that Section III - WHO IS AN INSURED is amended to include as an Additional Insured the person or organization shown in the schedule below as respects Coverages A. and B., but only with respect to liability arising out of your ongoing operations performed by you or on your behalf for that Additional Insured and not caused by or arising out of the actual or alleged independent liability of said Additional Insured. The entities scheduled below are covered under this Policy only for Limits of Insurance up to but not exceeding the amount required by the written contract with you and subject to the Limits of Insurance of this Policy. SCHEDULE Name of Person or Organization: ANY PERSON OR ORGANIZATION FOR WHOM YOU PERFORM WORK UNDER A WRITTEN CONTRACT TI IAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE WRITTEN CONTRACT MUST BE EFFECTIVE PRIOR TO THE DATE OF THE LOSS OCCURRENCE. All other terms and conditions of this Policy remain unchanged. Endorsement Number: 16 Policy Number: 12EMP4345212 Named Insured: L.T. ENVIRONMENTAL, INC. This endorsement Is effective on the inception date of this Policy unless otherwise stated herein: Endorsement Effective Date; 07/01/2017 00 EMP0091 00 05 06 1 of 1 d P116UU2ri1112 L.T. Environmental, Inc. Policy #12EMP4345212 Effective 07/01 /2017 - 07/01 /2018 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED/ PRIMARY COVERAGE INCLUDING COMPLETED OPERATIONS (COVERAGES A, B, D & F) This endorsement modifies insurance provided under the Environmental Multiline Policy It is agreed that Section III - WHO IS AN INSURED is amended to Include the following: Under Coverages A,B,D and F the person or organization shown in the schedule below shall be an Additional Insured, but only to the extent liability arises out of YOUR WORK for that Additional Insured and not due to any actual or alleged independent liability of said Additional Insured, This Endorsement does not apply to BODILY INJURY or PROPERTY DAMAGE arising out of the sole negligence or wiiltul conduct of, or for defects in design furnished by the Additional Insured. With respect to the coverage afforded to the Additional Insured, this insurance is primary and non- contributory, and our obligations are not affected by any other insurance carried by such Additional Insured whether primary, excess, contingent or on any other basis. f"his Endorsement does not increase the Company's limits of liability as specified in the Declarations of this policy. Additional Insured: ANY PERSON OR ORGANIZATION FOR WHOM YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE WRITTEN CONTRACT MUST BE EFFECTIVE PRIOR TO THE DATE OF THE LOSS OCCURRENCE All other terms and conditions of this Policy remain unchanged. Endorsement Number:15 Policy Number: 12EMP4345212 Named Insured: L.T. ENVIRONMENTAL, INC. This endorsement is effective on the inception date of this Policy unless otherwise stated herein: Endorsement Effective Date: 07/01/2017 00 EMP0101 00 01 14 1 of 1 r, 0 z w