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HomeMy WebLinkAbout109244 WASTE MANAGEMENT COLORADO LANDFILL DIVISION - INSURANCE CERTIFICATE (3),acoR[J' CERTIFICATE OF LIABILITY INSURANCE FDATE (MM/DD/YYYY) 1 / 1 /2018 1 12/7/2016 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 LOCKTON COMPANIES 5847 SAN FELIPE, SUITE 320 HOUSTON TX 77057 866-260-3538 CONTNAME:E: r PHONE FAX A/c No, Ext : A/C, No): E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAIC # INSURER A: ACE American Insurance Company 22667 INSURED WASTE MANAGEMENT HOLDINGS, INC. & ALL AFFILIATED, 1300436 RELATED & SUBSIDIARY COMPANIES INCLUDING: WASTE MANAGEMENT OF NORTHERN COLORADO INSURER B : Indemnity Insurance Co of North America 43575 INSURER C : ACE Property & Casualty Insurance Co 20699 INSURER D : ACE Fire Underwriters Insurance Company 20702 500 EAST VINE DRIVE INSURER E FORT COLLINS CO 80524 INSURER F COVERAGES CERTIFICATE NLIMRFR 1429072 RFVISIr1N1 NI IMRFI s 'VY'V V Y V V 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 INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DDlYYYY POLICY EXP PMOIL YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY Y N HDOG27860825 1/1/201.7 1/1/2018 EACH OCCURRENCE s 5,000000 CLAIMS -MADE 0 OCCUR DAMAGE AMAGPREMIESOERENTED oNTE ante 5,000,000 X MED EXP (Any oneperson) XXXXXXX XCU INCLUDED X ISO FORM CG00010413 PERSONAL & ADV INJURY $ 5,000,000 GENT AGGREGATE LIMIT APPLIES PER POLICY JE� LOC GENERAL AGGREGATE $ 6,000,000 PRODUCTS - COMP/OP AGG $ 6,000,000 OTHER A AUTOMOBILE LIABILITY Y N MMT H09052884 1/1/2017 1/l/2018 COMBINED SINGLE LIMIT Fa, a accident $ 1 000 000 ANY AUTO BODILY INJURY (Per person) $ XXXXXXX OWNED SCHEDULED( ONLY AUTOS 1xxx BODILY INJURY Per accident XXXXXXXAUTOS $HIRED NON -OWNED ONLY X AUTOS ONLY PROPERTY DAMAGEAUTOS Peracciden$ XXXX�C x MCS-90 $ XXXXXXX C X UMBRELLA LIAB X OCCUR Y N XOO G27929242 002 1/1/2017 I/1/2018 EACH OCCURRENCE $ 15,000,000 AGGREGATE $ 15,000,000 EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ XXXXXXX 13 A D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY N ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N WLR C49106944 AOS) WLR C49106907 (AZ,CA,&MA SCF C49106981 (WI) I/l/2017 I/l/2017 1/1/2017 1/1/2018 1/1/2018 I/l/2018 PER OTH- X STATUTE ER E.L. EACH ACCIDENT , $ �,000,000 E.L. DISEASE - EA EMPLOYEE 3,000,000 E.L. DISEASE - POLICY LIMIT 3,000,000 A EXCESS AUTO LIABILITY Y N XSA H09052872 1/1/2017 I/l/2018 COMBINEL) SINGLE L1MI'I $9,000,000 (EACH ACCIDENT) DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ADDITIONAL INSURED IN FAVOR OF THE CITY OF FORT COLLINS (COLORADO) (ON AI-L POLICIES EXCEPT WORKERS' COMPENSATION/EL) WHERE REQUIRED BY WRITTEN CONTRACT. I.CK 1 IrIk A 1 C MULUtK GANULLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 3429072 AUTHORIZED REPRESENTATIVE CITY OF FORT COLLINS P.O. BOX 580 FT, COLLINS CO 80524 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All riahts reserved The ACORD name and logo are registered marks of ACORD