HomeMy WebLinkAbout454406 BIOHABITS INC - INSURANCE CERTIFICATEi
AC"R I7® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
12l21 /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 policyll 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
CONTACT
NAME:
Klein Agency, LLC.
A/CNo Ext : (410)832-7600 A/C No): (410)832-1849
E-MAIL certs@kleinagencyllc.com
ADDRESS:
P.O. Box 219
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURERA: The Charter Oak Fire Insurance Co.
25615
Timonium MD 21094
INSURED
INSURER B : Travelers Indemnity Co. of CT
25682
INSURERC: Travelers Property Casualty Company of America
25674
Biohabitats, Inc.
INSURER D : The Phoenix Insurance Company
25623
2081 Clipper Park Road
INSURER E: Continental Casualty Company
20443
INSURER F:
Baltimore MD 21211-1406
COVERAGES CERTIFICATE NUMBER: 18-19 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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,
I
LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
EFF
MMLDDYYYYY
EXP
MM DDYYYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
�/
X
DAMAGE
1,000,000
CLAIMS -MADE OCCUR
PREMISES Ea occurrence
$
X
MED EXP (Any one person)
$ 10,000
Contractural Liability
PERSONAL& ADV INJURY
$ 2,000,000
A
660OJ612234
01/01/2018
01/01/2019
GEN'LAGGREGATE LIMITAPPLIES PER:
GENERAL AGGREGATE
$ 4,000,000
JECT LOC
POLICY JEC ❑
PRODUCTS - COMP/OPAGG
$ 4,000,000
Employee Benefits
$ 1,000,000
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
B
OWNED SCHEDULED
BAOJ630633
01/01/2018
01/01/2019
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
I PROPERTY DAMAGE
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Per accident
$
X
UMBRELLA LIAR
I X_
OCCUR
FACH OCCURRENCE
$ 4,000,000
AGGREGATE
$ 4,000,000
C
EXCESSLiA6
CLAIMS -MADE
CUPOJ633531
01/01/2018
01/01/2019
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
STATUTE EORH /�
E.L. EACH ACCIDENT
$ 1,000,000
D
ANY PROPRIETOR/PARTNER/EXECUTIVE
N/A
UBOJ634195All States Ind VA.
01/01/2017
01/01/2018
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
OFFICER/MEMBFREXCLUDED9
(Mandatory in NH)
If yes, describe under
1,C0v,D00
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
Each Claim
$5,000,000
Professional Liability/
E
Pollution Liability
ECH288389268
01/01/2018
01/01/2019
Aggregate
$5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: Project - 7616 Wetland, River & Floodplain Ecological Restoration See attached for specific additional insured wording.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
215 N. Mason Street
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
COMMENTS/REMARKS
If required under an insured written contract, executed prior to any loss, City of Fort
Collins are Additional Insured under the General Liability Policy, but only with respects
to liability arising from
work performed by or on behalf of Biohabitats, Inc.
If required under an insured written contract, executed prior to any loss, City of Fort
Collins are Additional Insured under the
Automobile Policy, but only with respects to liability arising from the operation of
vehicles by employees of Biohabitats, Inc.
If required under an insured written contract, executed prior to any loss, Waiver of
Subrogation is provided for City of Fort Collins under the General Liability, Automobile
Liability and Workers Compensation Policies.
It is further understood that coverage provided the Additional Insured under the General
Liability and Automobile Liability shall be primary and non-contributory to any other
coverage available to the Additional Insured.
I OFREMARK COPYRIGHT 2000, AMS SERVICES INC. I