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Home My WebLink AboutR A SMITH NATIONAL INC - INSURANCE CERTIFICATE (3)RASMITH-01 CTHOMPSON ACORO (MM/D �� CERTIFICATE OF LIABILITY INSURANCE DATE;MM/DD/YYYY) N 5/2017 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Johnson Insurance Milwaukee PHONE (g00 776-7055 FAX 877 254-8586 555 Main Street c N Utl: ) _ - (Alc No): ( ) Ste 291 noDAREss: info@johnsonins.com Racine, WI 53403 INSURER S) AFFORDING COVERAGE NAIC # INSURED R.A. Smith National, Inc. Chris Pinkowski 16745 W. Bluemound Rd, Ste 200 Brookfield, WI 53005-5938 INSURER A: Massachusetts Bay Insurance INSURER 13: Hanover Insurance Company INSURER C: RLI Insurance Company INSURER D : INSURER E : INSURER F : _ _..__ _ ___ - ..r.�•... r� ......r,rr,. RF\/ICIr1N NI IMRFR• 13056 vv r �nrw a_v 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. -- -- _ SM ILTR TYPE OF INSURANCE IN yyyp POLICY NUMBER PADM OLICY EFF MM/DDNYYY POLICY EXP MM/DD/Y LIMITS : A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,0001000 IMAGE To REnTE�— PREMISES Ea occurrence $ 100,000 U ZD1 D300583 00 CLAIMS -MADE OCCUR X 07/01/2017 07/01/2018 MED EXP (Any one person) $ 10,000 PERSONAL& ADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY ❑ JECT X LOC EBL AGG $ 1,000,000 OTHER: INGLE LIMIT $ 1,000,000 AUTOMOBILE LIABILITY Ea accident BODILY INJURY (Per person) $ B X AW1 D300725 00 07/01/2017 07/01/2018 BODILY INJURY (Per accident) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accideM $ UMBRELLA LIARX OCCUR EACH OCCURRENCE $ 5,000,000 B X EXCESS LIAR CLAIMS -MADE UH1 D300584 00 07/01/2017 07/01/2018 AGGREGATE $ - Prod Agg $ 6,000,000 DED RETENTION $ X PER OTH- WORKERS COMPENSATION STATUTE ER AND EMPLOYERS' LIABILITY Y/ N B WB1 D300745 on 07/01/2017 07/01/2018 E.L. EACH ACCIDENT $ 1,000,000 ANY FROPRIETORiPARTNERiEXECUTIVE FiTIN OFFICER/MEMBER EXCLUDED? /A E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under - - - -- -- -- E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below C Professional Liab RDP0029484 07/01/2017 07/01/2018 Per Claim 2,000,000 C Professional Liab RDP0029484 07/01/2017 07/01/2018 Aggregate 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins Colorado and The Larimer County Canal No. 2 Irrigation Company are additional insured l.Cr[ 1 I171VM I C "%J LIJ r_n The City of Fort Collins 300 LaPorte Ave. Fort Collins, CO 80521 CAAIltFI I ATIr)N 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 W 1 VOO-LO 1Y MV v1— --", . . .y.. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD