HomeMy WebLinkAboutCORRPRO COMPANIES INC - INSURANCE CERTIFICATE (5)ACO & CERTIFICATE OF LIABILITY INSURANCE
16-_� 7/1/2019
DATE(MM/DDYYYY)
6/20/2018
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 INSURERS), 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
Three City Place Drive, Suite 900
St. Louis M063141-7081
(314) 432-0500
CONT CT
NAME:
PHONE Ext : A/C, No
AIC
EMAIL
ADDRESS:
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: XL Insurance America. Inc.
24554
INSURED Con -pro Companies, Inc.
1316495 1055 W, Smith Road
Medina OH 44256
INSURER B : ACE American Insurance Company
22667
INSURER C: Indemnity Insurance Co of North America
43575
INSURER D : Starr Indemnity & Liabilii< Company
38318
INSURER E I
E�
INSURER F
COVERAGES CORC002 CERTIFICATE NUMBER: 11966279 REVISION NUMBER: XXXXXXX
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVF 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
Y
N
CGD300084903
7/1/2018
7/1/2019
EACH OCCURRENCE
$ 2.000,000
A
CLAIMS -MADE OCCUR
X
XCU / BROAD FORM PD
DAMAGE TO RENTED
PREMISES Ea occurrence)
$ 1,000,000
MED EXP (Any oneperson)
s 10,000
PERSONAL & ADV INJURY
$ 2 000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
POLICYa JE LOC
GENERAL AGGREGATE
$ 41000,000
PRODUCTS - COMP/OP AGG
$ 4,000,000
$
OTHER
B
AUTOMOBILE
LIABILITY
Y
N
ISA }I25158945
7/1/2018
7/1/2019
COMBINED SINGLE LIMIT
(Ea accident)$
5.000,000
X
BODILY INJURY (Per person)
$ XXXXXXX
ANY AUTO
AUTOS ONLY AUTOSULED
BODILY INJURY (Per accident
$ XXXXXXX
PROPERTY DAMAGE
Per accident
$XXXXXXX
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
$XXXXXXX
D
UMBRELLA LIAB
X
OCCUR
Y
N
1000095154181
7/1/2018
7/1/2019
EACH OCCURRENCE
$ 5,000,000
X
AGGREGATE
$ 5.000.000
EXCESS LIAB
CLAIMS -MADE
DED I J RETENTION $
$ XXXXXXX
B
C
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED? N❑
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
Y
WLRC65224987 (CA/MA)
WLRC6522494A (AOS)
(EXCLUDING MONOPOLISTIC)
7/1/2018
7/1/2018
7/1/2019
7/1/2019
PER OTH-
X STATUTE ER
E.L. EACH ACCIDENT
$ 1 ,000,OOO
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CITY OF FORT COLLINS - POUDRE CANYON 24#, PIPELINE REHABILITATION IS ADDITIONAL INSURED UNDER GENERAL LIABILITY ON A PRIMARY
AND NON-CONTRIBUTORY BASIS WHERE APPLICABLE BY WRITTEN CONTRACT, BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE NAMED
INSURED'S OPERATIONS, AND ARE ADDITIONAL INSUREDS UNDER AUTOMOBILE LIABILITY AND UMBRELLA LIABILITY WHEN REQUIRED BY WRITTEN
CONTRACT, BUT ONLY WITH RESPECT TO LIABILITY ARISING OUT OF THE NAMED INSURED's OPERATIONS. WAIVER OF SUBROGATION APPLIES
UNDER WORKERS' COMPENSATION WHERE PERMISSIBLE BY LAW AS REQUIRED BY WRITTEN CONTRACT EXECUTED PRIOR TO LOSS.
103 Al it I iaPYG\I 7i
11966279
CITY OF FORT COLLINS - POUDRE CANYON 24#
PIPELINE REHABILITATION
700 WOOD STREET
FORT COLLINS CO 80524
ACORD 25 (2016/031
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
5r5�__-V
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