HomeMy WebLinkAbout113700 INFRASTRUCTURE MANAGEMENT SERVICES INC - INSURANCE CERTIFICATEIMSINFR-01 ARACHEL
FACORO DATE (MM/DD/YYYY)
CERTIFICATE OF LIABILITY INSURANCE 04/12/2018
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 NAME CT April M. Rachel
American Insurance 81 Investment Corp. PHONE 877-1760 _ (FX 702 877-0937
6765 West Russell Rd Ext1:7O2 ) _ IAIC, Nog()
Ste 150 EWOR 11 s: april.rachel@american-ins.com
Las Vegas, NV 89118 ni-suneFarcl aFFnanIN(: CnVFReP.F NAtCr
INSURED
IMS Infrastructure Management Services, LLC
1820 W Drake Dr., Ste. 104
Tempe, AZ 85283
I INSURER C : Travelers Cas Ins Co of America 119046 1
INSURER E :
Co
f�G�TILI^ATC k1 IRACco. RFVICI(%KI MI IMRFR•
.. 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 SUBR TYPE OF INSURANCE ADDL POLICY NUMBER POLICY EFF POLICY EXP LIMITS
LTR iMMIDDMDM
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
1,000,000
CLAIMS -MADE [X] OCCUR
BFPD/XCU
X
6809H179210
03/26/2018
03/26/2019
DAMAGE TO�(E oN'cE,D
M
$ 1'000,000
X
MED EXP An one rson
$ 10,000
X
Contractual Liab.
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY IJ jEeT LOG
GENERAL AGGREGATE
2,000,000
$
PRODUCTS_-COMP/OPAGG
$ 2,000,000
OTHER
B
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident]
1,000,000
$ _.._ _
X ANY AUTO
X
BA8923L36A18GRP
03/26/2018
!, 03/26/2019
BODILY INJURY (Per person
$
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
AUE� oo
TOS ONLY A�TOS ONL�
PROPERTYlt AMAGE
$
B
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
CUP8666Y370
03/26/2018
03/26/2019
EACH_ OCCURRENCE
AGGREGATE _ _ _ _
$ 4,000,O N
$ 4,000,000
DIED I X I RETENTION $ 10,000
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMZER EXCLUDED?
(Mandatory in H)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
UB21<992554
04/19/2018
04/19/2019
X PER OTH-
_
1,000,000
$ _
I1000,ON
_$
1,000,000
$
E.L. EACH ACCIDENT __._
E.L. DISEASE - EA EMPLOYE_
E.L. DISEASE - POLICY LIMIT
D
Professional Liab.
106703766
03/25/2018 03/25/2019 Each Claim
2,000,000
D
Claims Made/Rpt'd
106703766
03/25/2018 03/25/2019 Aggregate
5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: 2015 Street Pavement Condition
Professional Liability Retro: FULL PRIOR ACTS
Workers Compensation Coverage Excludes: Alan Sadowsky
City of Fort Collins is named as addtitional insured with respects to General Liability and Auto Liability as per written contract.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
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
ACORD 25 (2016/03) CO 19BB-ZU15 AGUKU GUKF'UKA I IUIV. AN ngnis reserves.
The ACORD name and logo are registered marks of ACORD