FIELD DOCUMENTS_PART 2 FILE 2 - Laserfiche WebLink

Home Browse Search

CERTIFICATE OF LIABILITY INSURANCE DATE(''`"02014 ' 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), AUTHGRIZ.EO REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER IMPORTANT:It the certificate holder Is an I ONAL INSURED,the policy(its)must be andoread. If SUBROGATION IS W 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 certificals holder In lieu of such endorsement(s). PRODUCER ONTJCT O Aon Risk Services South, Inc. Franklin TN Office AIc.NaE,d). (866) 233 7122FA C.Na: 300363 0105 a 501 corpOrate Centre Drive ESL a Suite 300 ADDRESS: O Franklin TN 37067 USA INSURER(S)AFFOROINO COVERAGE MAIC a INSURED INSURER A: Greerwrich Insurance Company 22322 ArcadlS U.S. Inc. 630 Plaza Drive MURER0: XL Specialty Insurance co 37885 suite 200 INSURER Highlands Ranch CO 60129 USA eISUtlR D. IMSUNER E IHSURI<R F COVERAGES CERTIFICATE NUMBER:570053169741 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.L'MTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Limbs shown aro as requested T TYPE Of INSURANCE = POUC/NUMBER M L W ITS X "OM MERCMIGENERALLIABILITY GE EACHOCCURRENCE s1,000,OD0 cuuMSMADE EloccuR PRIEM w+.nta Sl,000,000 x ConbKWMLl.bary WED EXP(Ay—wmm) 510,000 PERSONAL A ADV MARY 51,000,000 Y GENL AGGREGATE LAUT APPLIES PER GENERAL AGGREGATE 12,000,000 POLICY OIPE T ❑X LOC PRODUCTS COMMOPAGG 52,000,000 !? OTHER }aC a AUTOMOBILE LJABLm AECO01075812 01/01/2024 01/01/2015 COM3wEOSINGLE LIMIT In AOS 11,000,000 a X ANY AUTO AE0001719510 01/01/2014 01/01/2015 BODILY INJURY I P*,pqn I O ALL AUTOS NEO SAUTCHEDULEDIIA BODILY INJURY(Per somem) E % NON-OWNEO PROPERTY OAMAGE A MWEDAUTOS X O AUTOS Pyr�cr1a•rIt X Prp.ry p�m�pF p AX UMBRELLA LIAB % OCCUR UEC 010 0110112014 01/01/201S EACH OCCURRENCL 11,000,006 L) EXCESS LUAB CLASASAUDE AGGREGATE 11,000,000 DED X TENTION IID,DOD B WORKERS COMPENSATION AND RWD 4 I PER DTH• EMPLOYERS'LIABILITY X 6TA7IfTE ANY PROFRIETOR(PARTNER/EXECUTIVE Y M All other States B OFFICERAIEMSEpEXCLDEOT NIA RWR943SI6708 01/01/2014 O1%D1/2025 EL EACIyACC10ENr 51,000,000 X91.deet".- NI £L DSEASE-EA EMPLOYEE 11,000,000 r �.MfeM�under D CRS?ION OF OPERATIONS bSbw EL DISEASE-PouCY Lim( 51,000,00 DlSCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD tel,AddKb l IlAlna rk6 StMtlub,K11y 6StlapMtl R RE: ARCADIS Project No. RV009840.0012.90DO3. Glenn Springs Holdings Inc. and Pacific Coast Supply, L.0 are Inc uded as �l Additional Insured in accordance with the policy provisions of the General Liability policy. 4= CERTIFICATE HOLDER CANCELLATION FA—LrTHOR:1ZZD ANY OF THE ABOVE DESCRIBED POLICIES OLE CANCELLED BEFORE THE N DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WRH THE PROVISIONS- I.- U.S., Inc. EPRESENTATIVE Attn: Scott Hackman 630 Plaza Drive, Suite 100 Highlands Ranch CO 80129 USAo>s 91J� � 01980.2014 ACORD CORPORATION.All rights reserved ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD