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HomeMy WebLinkAbout468473 VEOLIA ES TECHNICAL SOLUTIONS LLC - INSURANCE CERTIFICATE (12)A� f> CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/04/2017 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 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 Marsh USA, Inc. 540 W. Madison Street CONTACT NAME: PNC No. Extim A/C No : E-MAIL ADDRESS: Chicago, IL 60661 Attn: Veolia.CertRequest@marsh.com I Fax: 212-948-5053 INSURERS AFFORDING COVERAGE NAIC 0 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 : N/A N/A INSURER D : Lloyd's Syndicates 623/2623 Henderson, CO 80640 INSURER E : INSURER F : COVFRAGFS CERTIFICATE NUMBER: CHI-008065640-49 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/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDOG27873534 01/0112018 01/01/2019 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE 111 OCCUR DAMAGE TO RETE PREMISES Ea occur ence $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 X POLICY PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 1,000,000 $ OTHER: A AUTOMOBILE LIABILITY ISA H25098353 (AOS) 01/01/2018 01/01/2019 COMEaaBccINEDidnt SINGLE LiMll' e $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ A g WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN OFFIC RIMEMBEREXCLU ED?ECUTIVE I (Mandatory in NH) NIA WLRC64624131 (AOS) SCF C64624143 (WI) (Retro) 01/01/2018 01/01/2019 01/01/2019 X PER OTH- STATUTE ER E.L.EACHACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below D Pollution Legal Liability W1D4C8170101 01/01/2018 01/01/2019 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. CFRTIFICATF HOI nFR CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Purchasing Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Attn: Ed Bonnette, CPM ACCORDANCE WITH THE POLICY PROVISIONS. 215 North Mason P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee Maen�ea►ul.at�.nr e ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD