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HomeMy WebLinkAbout110168 U S ENGINEERING CO - INSURANCE CERTIFICATE (13)ACORN° CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 7/31/2019 1 7/6/2018 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 Lockton Companies 444 W. 47th Street, Suite 900 Kansas City MO 64112-1906 (816) 960-9000 CONT CT NAME: A/c, PHONE FAX EXt : Arc, No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Insurance Company 23043 INSURED U.S. ENGINEERING COMPANY 1354733 3433 ROANOKE ROAD KANSAS CITY MO 64120 St. Paul Fire and Marine Insurance Company INSURER B : P Y _4767 INSURER C : INSURER D : INSURER E: INSURER F : COVERAGES* CERTIFICATE NUMBER: 11886393 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y Nl TB5-Z91-457358-018 7/31/2018 7/31/2019 EACH OCCURRENCE 2,000,000 PREMISES (E. olc."ence 300,000 MED EXP (Any oneperson) 10000 PERSONAL & ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ECT LOC OTHER: GENERAL AGGREGATE $ 4,000,000 PRODUCTS - COMP/OP AGG $ 4,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO NED AUTOS ONLY AUTODULED AUTOS ONLY AUUTOS ONLDY Y N AS7-Z91-457358-038 7/31/2018 7/31/2019 Ea aaaden SwGLE LIMIT $ 1 000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX Peer a cidentDAMAGE $ XXXXXXX Comp/Coll Deds. $ 2,000 B UMBRELLA LIAB EXCESS LIAB NXOCCUR CLAIMS -MADE N N ZUP-31M37065-18-NF 7%3112018 7/31/2019 EACH OCCURRENCE $ 51000,000 X AGGREGATE $ 5,000 000 DED I I RETENTION $ $ XXXXXXX P WORKERS COMPENSATION AND EMPLO ERS' LIABILITY Y / N ANY OFFICERIMEMBER/EXCLUDED? ECUTIVE 1 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N WA2-Z9D-457358-028 7/31/2018 7/31/2019 X STATUTE GER E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE $ 1 OOO OOO E.L. DISEASE - POLICY LIMIT 1z 1.000.000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ALL OPERATIONS CONDUCTED BY THE INSURED. CITY OF FORT COLLINS, ITS OFFICERS, AGENTS AND EMPLOYEES ARE ADDITIONAL INSUREDS AS RESPECTS GENERAL LIABILITY AND AUTO LIABILITY WHERE REQUIRED BY WRITTEN CONTRACT. FOR CANCELLATION FOR ANY REASON OTHER THAN NONPAYMENT OF PREMIUM, THE INSURER(S) WILL SEND 30 DAYS NOTICE OF CANCELLATION TO THE CERTIFICATE HOLDER. UtK I If-IUA I t NULUtK L:ANL:tLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11886393 AUTHORIZED REPRESENTATIVE CITY OF FORT COLLINS PO BOX 580 FORT COLLINS CO 80522 i 40-7 iie7 411e • ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD