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HomeMy WebLinkAbout125216 WALSH ENVIRONMENTAL LLC - INSURANCE CERTIFICATE (4)Page 1 of 1 AIR" CERTIFICATE OF LIABILITY INSURANCE D 07/26/2017Y) 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 have ADDITIONAL INSURED provisions or 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: PHONE FAX JA No Ext: 1-877-945-7376 1-888-467-2378 A/C No: Willis of New York, Inc. c/o 26 Century Blvd P.O. Box 305191 E-MAIL ADDRESS: certificates®willis.com INSURERS AFFORDING COVERAGE NAIC# Nashville, TN 372305191 USA INSURER A: Great Divide Insurance Company 25224 INSURED INSURERB: Federal Insurance Company 20281 Walsh Environmental, LLC 4949 Pearl E Circle, Suite 300 INSURERC: INSURER D: Boulder, CO 80301 USA INSURER E : INSURER F : CPIVFRA(_Fq CFRTIFICATF NIIMRFP- W3086528 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 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. INSRPOLICY LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER EFF MWDDNYYY POLICY EXP MM/ DNYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 3,000,000 7:;71 CLAIMS -MADE OCCUR DAMAGE TO RENTE PREMISES Eaocccurence $ 1,000,000 MED EXP (Any one person) $ 30,000 A Contractual Y N GLP200597715 08/01/2017 08/01/2018 PERSONAL & ADV INJURY $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OPAGG $ 3,000,000 POLICY � JEo X LOC $ OTHER: AUTOMOBILE LIABILITY CO MBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY N N BAP200598315 08/01/2017 08/01/2018 PROPERTY DAMAGE Per accident $ B UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE N N 79872763 08/01/2017 08/01/2018 EACH OCCURRENCE $ 15,000,000 X AGGREGATE $ 15,000,000 DED I I RETENTION $ Prod/Compl Ops. $ 15,000,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE PER OTH- STATUTE ER E.L. EACH ACCIDENT $ OFFICER/MEMBEREXCLUDED? (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $ If yes, describe unaer DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The Excess Liability policy supports the General Liability and Automobile Liability. RE: P1066 Environmental Services --- The City of Fort Collins is named as an additional insured on the general liability as required by written contract. L;hH I It-IGA I t MULUthi liN1V{ CLLN I IVIl City of Fort Collins 215 North Mason Street P.O. Box 580 Fort Collins, CO 805220580 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 4�1>___' ■ ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD SR ID: 14875802 BATCH: 394623