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Home My WebLink About468473 VEOLIA ES TECHINCAL SOLUTIONS LLC - INSURANCE CERTIFICATE-�, ® AiiC"Ra CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 01/04/2017 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 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 Marsh USA, Inc. 540 W. Madison StreetL Chicago, IL 60661 Attn: Veolia.CertRequest@marsh.com Fax: 212-948-5053 CONTACT NAME,__- PHONE FAX / o A/C No : E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # _ INSURER A: ACE American Insurance Company 22667 _HEN-TS INSURED Veolia ES Technical Solutions, LLC 9131 East 96th Avenue INSURER B : ACE Fire Underwriters Insurance Company 20702 INSURER C : NIA N/A INSURER D : Lloyd's Syndicates 623/2623 Henderson, CO 80640 INSURER E : INSURER F : nn�rcowr_�c f`GRTIGIr_ATE NUMBER: CHI-005218840-49 REVISION NUMBER: 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 SUBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDO G27860497 01/01/2017 01/01/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 PRODUCTS - COMP/OP AGG $ 1,000,000 POLICY PRO-❑ LOC X JECT OTHER: A AUTOMOBILE LIABILITY ISA H09052677(AOS) 01/01/2017 01/01/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ - UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE _ DED RETENTION $ $ A WORKERS COMPENSATION WLR C49107493 (AOS) 01/01/2017 01/01/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 B AND EMPLOYERS' LIABILITY YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A SCF C49107535 (WI) (Retro) 01/01/2017 01101/2018 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E L. DISEASE -POLICY LIMIT $ 1,000,000 D Pollution Legal Liability W04C8170101 01/01/2017 01/01/2018 Per Claim 1,000,000 Claims Made Form SIR $750,000 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, its officers, agents and employees are included as additional insured where required by written contract but only for liability arising out of the operations of the named insured with respect to General Liability and Auto Liability. CERTIFICA I t t1ULUtK I "'^ City of Fort Collins Purchasing Division Attn: Ed Bonnette, CPM 215 North Mason P.O. 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 of Marsh USA Inc. Manashi Mukherjee V Iy00-Au I9 k"Air i %1W I IyI Iw .cam ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD