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HomeMy WebLinkAbout20021496.tiff DATE ACORDTM CERTIFICATE OF LIABILITY INSURANCE Page 1 of 3 05/31/2002 PRODUCER 877-559-6769 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis North America, Inc. - Regional Cert Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11201 N. Tatum Boulevard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 300 Phoenix, AZ 85028 INSURERS AFFORDING COVERAGE INSURED SEE Support Services, Inc. INSURERA: Zurich American Insurance Company 16535-002 14900 Landmark Boulevard INSURERS: American Guarantee and Liability Insuranc 26247-001 Suite 400 Dallas, TX 75254 _ INSURER C: INSURER D: I INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY EFFECTIVE POLICY EXPIRATION ILTR TYPE OF INSURANCE POLICY NUMBER DATF(MM/DD/YY) DATE(MM/DDNY1 LIMITS A GENERAL LIABILITY GLO234708300 6/1/2002 6/1/2003 EACH OCCURRENCE $ 1,000,000 • X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE(Any one tire) $ 50,000 CLAIMS MADE X OCCUR MEDEXP(Any one person) $ 5,000 PERSONAL 4ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY P III IT LOC A AUTOMOBILELIABIUTY AOS BAP234708500 6/1/2002 6/1/2003 COMBINED SINGLE LIMIT $ 1,000,000 B X ANY AUTO TX TAP234708400 6/1/2002 ,.,en'nosstJ (Ea accident) ALL OWNED AUTOS - BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS I PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ IOCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ _ $ WORKERS COMPENSATION AND .AOS WC234708200 6/1/2002 6/1/3003 X 1 oaYrA.is! _' ER A EMPLOYERS'LIABILITY • E.L.EACH ACCIDENT $ 1,000,000 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 E.L.DISEASE-POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS All policies indicated are primary and non-contributory as respects any other insurance in force. It is a condition of the General Liability policy that the general aggregate applies on a per project basis. CERTIFICATE HOLDER I I ADDITIONAL INSURED;INSURER LETTER: _ CANCELLATION except 10 days for Non-pement SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRrITEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Board of County Commissioners of Weld County REPRESENTATIV . 915 Tenth Street AUTHORIZED P ENTATIVE Greeley, CO 80632 ACORD 25-S(7/97) Co11:466698 Tp1:96215 Cert:1847763 2002-1496 DarE Willis CERTIFICATE OF LIABILITY INSURANCE Page 2 of 3 05/31/2002 PRODUCER 877-559-6769 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis North America, Inc. - Regional Cart Center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11201 N. Tatum Boulevard ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 300 Phoenix, AZ 85028 INSURERS AFFORDING COVERAGE INSURED SEE Support Services, Inc. INSURERA: Zurich American Insurance Company 16535-002 14900 Landmark Boulevard INSURERB: American Guarantee and Liability Insuranc 26247-001 Suite 400 Dallas, TX 75254 INSURERC: INSURER D: INSURER E: DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: All operations of the insured during the Performance Period: 01 Jan 2001 through 31 Dec 2002 It is a condition of the General Liability, Automobile Liability and Workers' Compensation policies that Weld County, Colorado and Weld County Library Association are hereby added as additional insureds, only to the extent assumed by the insured under the written contract, subject to the policy terms, conditions and exclusions. Co11:466698 Tp1:96215 Cert:1847763 Page 3 of 3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD25-S(7/97) Coll:466698 Tp1:96215 Cert:1847763 Hello