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HomeMy WebLinkAbout109244 WASTE MANAGEMENT OF NORTHERN COLORADO - INSURANCE CERTIFICATE (3)ACORlj' CERTIFICATE OF LIABILITY INSURANCE
16-.� 1/1/2019
DATE(MM/DD/YYYY)
12/ 11 /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 LOCKTON COMPANIES
3657 BRIARPARK DRIVE, SUITE 700
HOUSTON TX 77042
866-260-3538
CONTACT
NAME:
HONE
A c, No, Ext : Arc, No):
E-MAIL
ADDRESS:
INSURERS 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 Fire Underwriters Insurance Company
20702
INSURER D :
500 EAST VINE DRIVE
INSURER E :
FORT COLLINS CO 80524
INSURER F
COVERAGES CERTIFICATE NUMBER: 3429072 REVISION NUMBER: XXXXXXX
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/DD/YYYY
POLICY EXP
(MMIDD/YYYYI
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
N
HDO G27873091
1/1/2018
1/1/2019
EACH OCCURRENCE
5,000 000
CLAIMS -MADE FX—] OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
S,000 OOO
X
MED EXP (Any oneperson)
XXXXXXX
XCU INCLUDED
X
ISO FORM C000010413
PERSONAL & ADV INJURY
$ 5,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
P1POLICY JERCOT LOC
GENERAL AGGREGATE
$ 6,000,000
PRODUCTS - COMP/OP AGG
$ 6,000,000
$
OTHER
A
AUTOMOBILE
LIABILITY
Y
N
MMTH25097890
1/1/2018
1/1/2019
COMBINEDSINGLE$
1,000,000
X
BODILY INJURY (Per person)
$ XXXXXXX
ANY AUTO
AOUTOS ONLY AUTOSULED
X
BODILY INJURY (Per accident
$ XXXXXXX
X
AUTOS ONLY X AUTOS OINLDY
PROPERTY
accldenDAMAGE
$ XXXXXXX
X
$ XXXXXXX
MCS-90
A
X
UMBRELLA LIAB
NCLAIMS-MADE
OCCUR
Y
N
XOO G27929242 003
1/1/2018
1/1/2019
EACH OCCURRENCE
$ 15,000,000
AGGREGATE
$ 15,000,000
EXCESS LIAR
DED I I RETENTION $
$ XXXXXXX
B
A
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED
(Mandatory in NH)
pJ / A
N
WLR C6462278A (AOS)
WLRC64622778/`A,Z,CA,&MA
SCF C6462279I (W 1)
1/1/2018
1/1/2018
1/1/201 g
1/1/2019
1/1/2019
I/I /20I9
PER OTH-
X STATUTE ER
EL EACH ACCIDENT
}
$ 3,000,000
E.L. DISEASE - EA EMPLOYEE
3,000,000
E.L. DISEASE - POLICY LIMIT
3,000,000
Ifyes. describe under
DESCRIPTION OF OPERATIONS below
A
EXCESS AUTO
LIABILITY
Y
N
XSA H25097889
1/1/2018
1/1/2019
COMBINED SINGLE LIMIT
$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 ALL POLICIES EXCEPT WORKERS'
COMPENSATION/EL) WHERE REQUIRED BY WRITTEN CONTRACT.
1, IFNI11 1l m I L UlwL rN I,HIYV CLLH I IVIY
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 (2016103) ©1988-2015 ACORD CORPORATI - All riahts reserved
The ACORD name and logo are registered marks of ACORD