HomeMy WebLinkAbout102630 AYRES ASSOCIATES INC - INSURANCE CERTIFICATE (11)AC �® DATE (MM/DD/YYYY)
�� CERTIFICATE OF LIABILITY INSURANCE 12/19/2017
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 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 endorsements .
PRODUCER CONTACT
NAME: Sharon Bannach
Arthur J. Gallagher Risk Management Services, Inc. PHONE FAx
245 South Executive Drive, Suite 200 UVC_N.,, gyp. 262-792-2214 M) 262-792-1712
E-MAIL Sharon_Bannach@a
Brookfield WI 53005 ADDRESS: Jg•com
INJUKEK(S) AFFORUING COVERAGE NAIC #
INSURER A: Travelers Property Casualty Co of America 25674
INSURED AYREASS-02 INSURER B:The Travelers Indemnity Company of CT 25682
AYRES ASSOCIATES INC INSURERC:
3433 Oakwood Hills Parkway
Eau Claire, WI 54702-1509 INSURERD:
Cr1VFRa(:FC f CDTICI!`ATC KII IRAQCD. dQi2l r1rrr, ortncrnwl Ru IRADCn.
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 15 SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
- --
INSR � �
TYPE OF INSURANCE POLICY EFF ' POLICY EXP LIMITS
LTR � N D WVD POLICY NUMBER i MMIDD/YYYY MMIDDlYYYY
A
X
COMMERCIAL GENERAL LIABILITY
Y
P6302183P260TIA18 1/1/2018
1/1/2019
EACH OCCURRENCE
E1,000,000
CLAIMS -MADE ❑X OCCUR
PREMISES Ea occurrence
$100,000
MED EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GENT AGGREGATE LIMIT APPLIES PER:
x POLICY PRO-
JECT El LOC
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP/OP AGG
$2,000,000
OTHER:
E
A
AUTOMOBILE
LIABILITY
Y
P810379OP125TIL18
1/1/2018
1/1/2019
BINED SINGLE LIMIT
Eaaccident
E1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
BODILY INJURY (Per accident)
$
X
DAMAG
Per accident
$
S
A
X
UMBRELLA LIAB
X
OCCUR
PSMCUP379OP149TIL18
1/1/2018
1/1/2019
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000,000
EXCESS LIAB
CLAIMS -MADE
DED x RETENTION $0
E
g
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y /N
ANY NOFFICERIMEMBER/PARTEXCLUDED? EGUTIVE
(Mandatory in NH)
If yyes, describe under
N/A
UB9H943775018
1/1/2018
1/1/2019
X STATUTE EORH
E.L. EACH ACCIDENT
S1,000,000
E.L. DISEASE - EA EMPLOYEE
E 1,000,000
E.L. DISEASE - POLICY LIMIT
$1,000,ODO
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: 8073 Engineering Services for Water, Wastewater & Stormwater Facilities Capital Improvements.
The City of Fort Collins is named as Additional Insured on the General Liability policy per from CIS D2 47 08 05 and Auto Liability as per form
CAT3 53 0310.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
The City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
215 N. Mason Street ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins CO 80524
AUTHORIZED REPRESENT TIVE
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