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HomeMy WebLinkAbout571438 HEMENWAY GROUNDWATER ENGINEERING INC - INSURANCE CERTIFICATE (2)A a® CERTIFICATE OF LIABILITY INSURANCE 8/6/ 018 THIS CERTIFICATEIS 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 endorsements . PRODUCER HUB INTL MTN STATES LTD/PHS 344399 P: (866) 467-8730 F: (888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: WC,Exq: (866) 467-8730 ONE (.N.): (888) 443-6112 ADDRIESS* INSURER(S) AFFORDING COVERAGE NAIL# INSURER A: Hartford Casualty Ins Co INSURED HEMENWAY GROUNDWATER ENGINEERING, INC. LN AVE PMB 416 17011 LINCO80134 O PARKER CO 0 1 3 4 INSURER B: INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 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. INSB TYPE OF INSURAA'CE ADDI SURR POLICYNUAMER � Y'EFY POLICYEXP OWMAWMIal LLW17S COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) 5 3 O O, 0 0 0 X X MED EXP (Any one person) 510, 000 A General Liab 34 SBA UH3744 09/01/2018 09/01/2019 PERSONAL & ADV INJURY $1, 0 0 0, 0 0 0 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY � PER ❑X LOC JCT GENERAL AGGREGATE s2,000,000 PRODUCTS -COMP/OP AGG S 2, O O O , O O O OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $1 O O O, O O O r BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS 34 SBA UH3744 09/01/2018 09/01/2019 X BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $11 000, 000 A EXCESS LIAB CLAIMS -MADE 34 SBA UH3744 09/01/2018 09/01/2019 X AGGREGATE $11000, 000 DE X RETENTION $1 O, 0 0 0 $ WORNERSCOAMENSATION ANDENPLOMRS'LIAAMMY PER OTH- STATUTE I JER E.L. EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) ❑ MIA E.L. DISEASE -EA EMPLOYEE $ If yes, describe under E.L. DISEASE LIMIT DESCRIPTION OF OPERATIONS below -POLICY DESCRIPTION OF OPERATIONS /LOCATIONS/VEHIC*KX)RD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. Certificate holder is an additional insured per the Business Liability Coverage Form SS0008, the Hired Auto and Non -Owned Auto Endorsement SSO438 and the Umbrella Liability Provisions Form SX8003, attached to this policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City of Fort Collins PO BOX 580� AUTHORIZED REPRESENTATIVE FORT COLLINS, CO 80522 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD