COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

OP ID: MT 71IW0122/12 (MDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 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 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 Phone: 800-746-0048 CONTACT NAME Marl se Taylor Van Oppen 8 Co.2,Inc. Fax: 303-232-6738 PHONE g00-746-0048 FA No 303-232-6738 P.O.Box 793 AIC No Ext Teton Village,WY 83025 A DRESS service@vanoppenco2.com PRODUCER ODICE-1 CUSTOMER ID# INSURER(S)AFFORDING COVERAGE NAIC# INSURED ODIC Environmental INSURER Starr Indemnity&Liability 38318 3255 Wilshire Blvd.,#1510 INSURER B Hartford Fire Insurance Co. 19682 Los Angeles,CA 90010 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. INSR DDL UBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MWDDNYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIAB LITY SISIEIL70063712 10/21/12 10/21/13 PREMISES Ea occurrence $ 300,00 CLAIMS-MADE 1XI OCCUR MED EXP(Any one person) $ 10,00 X CPL PERSONAL&ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE L MIT APPL ES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 X POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,00 A ANY AUTO SISIEIL70063712 10/21/12 10/21/13 (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNEDAUTOS $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,00 X EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4,000,00 A SISIXNV71026112 10/21/12 10/21/13 DEDUCTIBLE $ X RETENTION S 0 $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY X TORY LIMITS ER B ANY PROPR ETOR/PARTNER/EXECUTIVE YNIA 57 WEC VV8104 04/01/12 04/01/13 E.L.EACH ACC DENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 1,000,00 If yes,describe under DESCR PTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,00 A Professional Liab SISIEIL70063712 10/21/12 10/21113 Ea Claim 1,000,00 "Claims Made" SUBJECT TO GL AGGREGATE lAggregate 2,000,00 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space Is required Umbrella policy provides additional limits/coverage over primary Genera Liability, Contractors Pollution Liability, Professional Liability, Auto Liability and Employer's Liability CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE General Info THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE f��en I ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD