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HomeMy WebLinkAbout468473 VEOLIA ES TECHNICAL SOLUTIONS LLC - INSURANCE CERTIFICATE (13)AC40Rf> CERTIFICATE OF LIABILITY INSURANCE 111*�. DATE (MM/DD/YYYY) 1210412017 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: PHONE FAX IAIC. No. ExtIE ac No): E-MAIL ADDRESS: Chicago, IL 60661 Attn: Veolia.CertRequest@marsh.com j Fax: 212-948-5053 INSURERS AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 LOM- INSURED Veolia ES Technical Solutions, LLC INSURERS: AIG Specialty Insurance Company 26883 INSURER C : N/A N/A 700 East Butterfield Road, Suite 201 INSURER D : ACE Fire Underwriters Insurance Company 20702 Lombard, IL 60148 INSURER E : Lexington Insurance Company 19437 INSURER F : COVERAGES CERTIFICATE NUMBER: CHI-007496336-38 REVISION NUMBER: 5 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 POLICYNUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY HDO G27873534 01/01/2018 01/01/2019 EACH OCCURRENCE $ 1.000,000 CLAIMS -MADE OCCUR PREMISES Ea oNED ccurrence) $ 1,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,0W GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 POLICY � PRO- JECT D LOC PRODUCTS - COMP/OP AGG $ 1,000,000 Is OTHER A AUTOMOBILE LIABILITY ISA H25098353 (AOS) 01/01/2018 01/01/2019 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED RETENTION $ $ A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) NIA WLR C64624131 (AOS) SCF C64624143 (WI) (Retro) 01/0112018 01/01/2019 01101/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E L. DISEASE - POLICY LIMIT $ 1,000,000 B CPL- SIR: $500,000 CP029329661 01/01/2018 01/01/2019 Occurence/Aggregate 1,000,000 E E&O - SIR: $2,000,000 065703643 01/01/2018 01/01/2019 Per Claim/Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as additional insured (except as respects all coverage afforded by workers' compensation and professional liability) where required by written contract but only for liability arising out of the operations of the named insured. A waiver of subrogation is granted as required by written contract but only for liability arising out of the operations of the named insured. ltla:i112L•L•\Ia:Lei III 9JR: �' • City of Fort Collins 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 Mauaes►. i h j ©1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD