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Home My WebLink About20031575 DATE ACORD,A, CERTIFICATE E OP LIABILITY INSURANCE page 1 of 3 06/02/2003 - PRODUCER 877-559-6769 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis North America; 15a.' —Replcaal Cettr-center HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 11201 N. Tatum Bo141svatd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 300 Phoenix, AZ 85026 - - INSURERS AFFORDING COVERAGE INSURED I t'— SEE Support Services, Inc. INSURER A: Zurich American Insurance Company 16535-002 14900 Landmark Boulevard INSURERS:American Guarantee and Liability Insuranc 26247-001 Suite 400 Dallas, TX 75254 INSURERC:Zurich American Insurance Company 16535-005 INSURER 0: 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. ILTR TYPE OF INSURANCE POLICY NUMBER OAT MOM MMNEOIYYI I P8ATEfMM/DOIYYN I OMITS A GENERAL LIABILITY GL0234708301 6/1/2003 6/1/2004 EACH OCCURRENCE $ 1.000,000 X COMMERCIALGENERALLIABIUTY FIRE DAMAGE(Any one fire) S 50,000 GAMS MADE I X I OCCUR MEDEXP(Mycne penan) a 5,000 PERSONAL&ADS INJURY S 1.000,000 GENERAL AGGREGATE S 5.000.000 GEN'LAGGREGATE UppMQII.T.APPLIES PER: PRODUCTS-COMP/OP AGG S 2.000.000 n POUCY n..7811 n LOC , A AUTOMOBILE LIABILITY (ADS) BAP234708501 6/1/2003 6/1/2004 COMBINED SINGLE OMIT 5 1'000,000 B X ANY AUTO (TX) TAP234708401 6/1/2003 6/1/2004 (Ea accident) C ALL OWNED AUTOS (VA) BAP937422100 6/1/2003 6/1/2004 BODILY INJURY S SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY S NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE S (Per accident) GARAGE UABILITY • AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN EA ACC S AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE S nOCCUR n CLAIMS MADE AGGREGATE S S DEDUCTIBLE 5 RETENTION S 5 A WORKERS COMPENSATION AND AOS WC234708201 6/1/2003 6/1/2004 X IToivIT.I%I •BI Kg' EMPLOYERS'LIABILITY E.L EACH ACCIDENT 5 1,000.000 E.L.DISEASE•EA EMPLOYEE 5 1,000.000 EL.DISEASE-POLICY LIMIT S 1.000.000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL 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-paya.nt SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTAT Board of County Commissioners of Weld County 915 Tenth Street AUTHORIZED ENTATWE Greeley, CO 80632 8C 2 S Coll:737594 Tp1:176662 Cert:3101780 @ACORDrnoonoer,n.,.,...,. "G/2� �itO'�L. /e G 2003-1575 DATE WI�115 CERTIFICATE OF LIABILITY INSURANCE Page 2 of 3 06/02/2003 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 SAE 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 INSURERC:Zurich American Insurance Company 16535-005 • INSURER 0: INSURER E DESCRIPTION OF OPERATIONSROCATONSNENICLESIEXCLUSIONS ADDED BY ENOORSEMENTISPECIAL 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. Co11:737594 Tp1:176662 Cart:3101780 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. • ACORD 25-S(7/97) Co11:737594 Tp1:176662 Cart:3101780 Hello