HomeMy WebLinkAbout612352 ARCA RECYCLING INC - INSURANCE CERTIFICATE (5)'
AC"R " CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDNYYY)
06/04/2018
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
Marsh USA Inc.
333 South 7th Street, Suite 1400
Minneapolis, MN 55402-2400
Attn Minneapolis.CertRequest@marsh.com Fax 212-948-0114
CONTACT
NAME______
PHONE FAX
A/c No):
E-MAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: NIA
N/A
INSUREDARCARecycling, Inc.
175 Jackson Avenue North
INSURER B : N/A
N/A
INSURER C : NIA
N/A
INSURER D: Allied World Assurance Company U.S. Inc.
19489
Suite 102
Hopkins, MN 55343
INSURER E :
INSURER F :
CnVFRAGFR CERTIFICATE NUMBER: CHI-007161690-15 REVISION NUMBER: 14
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
WVDSUBRI
POLICY NUMBER
POLICY EFF
MM DD/YYYY)
POLICY EXP
(MMIDDfYYYYI
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
CLAIMS -MADE OCCUR
DAMAGE To RENTED
PREMISES Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GEN1
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
POLICY ❑ PRO -
POLICY ❑ LOC
PRODUCTS - COMPIOP AGG
$
$
OTHER
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY L AUTOS ONLY
BODILY INJURY (Per accident)
$
PROPERTYDAMAGE
Per accident
$
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
HCLAIMS-MADE
AGGREGATE
$
EXCESS LIAR
DED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
PER OTH-
STATUTE IER
E.L. EACH ACCIDENT
$
OFFICER/MEMBER EXCLUDED? ❑
NIA
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
D
Contractors Pollution
0308-6513
06/01/2018
06/01/2019
SIR: $25,000 Limit:
5,000,000
D
Professional Liability
0308-6513
06/01/2018
06/01/2019
SIR: $25,000 Limit:
5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Fort Collins, officiers, agents, and employees are included as additional insured where required by written contract with respect to Contractors' Pollution.
CGOTICICATF' 14nl 1116=0 CANCFI I ATIAN
The City of Fort Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Attn: Purchasing Dept.
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
PO Box 580
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80522
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Manashi Mukherjee �iasr�aa►.Y^ a��yjc t
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ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD