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HomeMy WebLinkAboutR A SMITH NATIONAL INC - INSURANCE CERTIFICATE (2)RASMITH-01 CTHOMPSON A�O�RO CERTIFICATE OF LIABILITY INSURANCE DATE 07/02/2018Y) 07/02/2018 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 INURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subiect 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 C NTACT N ME: Johnson Insurance Milwaukee PHONE FAX 1103 Hunter Drive (A1C, No, Ext): (800) 776-7055 (A/C, Nri:(877) 254-8586 Mount Pleasant, WI 53406 1 kpp jss: inkdaohnsonins.com INSURED R.A. Smith National, Inc. Chris Pinkowski 16745 W. Bluemound Rd, Ste 200 Brookfield, WI 53005-5938 INSURER F : Cr1VFRARFC rFRTIFICATF NI IMRPR- RFVISIr)N NI 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 TYPE OF INSURANCE ADDL SUBR vivo POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A TMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR AGGREGATE LIMIT APPLIES PER: POLICY I JECT I " LOC OTHER X ZD1D300583 07/01/2018 07/01/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED P MI E E curve 100,000 $ MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OPAGG $ 2,000,000 rI EBL AGG $ 1,000,000 B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON- MED AUTOS ONLY AUTOS ONLY AW1 D300725 07/01/2018 07/01/2019 COMBINED SINGLE LIMIT Eq accident __-_. BODILY INJURY Perperson) 11000,000 $ X _ $ BODILY INJURY Per accident $ P PERTY AMAGE er accig $ B UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMS -MADE UH1D300584 07/01/2018 07/01/2019 EACH OCCURRENCE 10,000,000 $ X AGGREGATE $ DED RETENTION $ Prod Agg 10,000,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� FFICER/MEMBER EXCLUDED? " J ( andatorym NH) If yes, describe under DESCRIPTION OF OPERATIONS below N 1 A � WB1 D300745 07/01/2018 I 07/01/2019 X PER OTH- TAT R E.L. EACH ACCIDENT 1,000,000 $ _E.L DISEASE-_F1�EMPLOYEE 1,000,000 ___________,._. E.L. DISEASE -POLICY LIMIT 1,000,000 C C IProfessional Liab Professional Liab i RDP0029484 RDP0029484 07/01/2018 07/01/2018 07/01/2019 07/01/2019 lPer Claim Aggregate 2,000,000 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) The City of Fort Collins Colorado and The Larimer County Canal No. 2 Irrigation Company are additional insured I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE The City of Fort Collins JUL ' 6 201g THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 LaPorte Ave. Fort Collins, CO 80521 City Manager's OffICE' AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD