HomeMy WebLinkAboutCERT OF LIABILITY INSURANCE From:Stephanie Penaluna At:First Iowa Insurance Agency FaxID:3193933161 To:City of Waterloo Date:10/23/2009 10:54 AM Page:2 of 3
ACORD CERTIFICATE OF LIABILITY INSURANCE OPID SP DATE(MM/DDYYYY)
DWZIN-1 10/23/09
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
First Iowa Insurance Agency HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
4201 Glass RD NE, PO Box 997 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Cedar Rapids IA 52406-0997 •
Phone: 319-393-5262 Fax:319-393-3161 INSURERSAFFORDINGCOVERAGE NAIC#
INSURED INSURER A: Aestem National Mutual Ins.
INSURER B. Aspen Insurance UK Limited
DW Zinser Company, Inc. INSURERC: Crum & Forster Specialty Chris Zinser p y
1775 Commercial Drive INSURER D:
Walford IA 52351
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.
IMP(AUL,L POLICY EI•FEt I IVE POLICY EXPIRA❑ON LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X X COMMERCIAL GENERAL LIABILITY CPP1014487 10/18/09 10/18/10 PR MISES(Ea ccuence) $100,000
CLAIMS MADE X OCCUR MED EXP(Any one person) $5,000
PERSONAL&ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000
PRO-
POLICY X JET LOC
AUTOMOBILE LIABILITY
A X X ANY AUTO CPP1014013 10/18/09 10/18/10 COMBINED SINGLE LIMIT $1 000 QOD
CO BINED i
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $2,000,000
C X OCCUR CLAIMS MADE XS0131038 09/01/09 02/04/10 AGGREGATE $2,000,000
DEDUCTIBLE
X RETENTION $0 $
WORKERS COMPENSATION AND X TORY LIMITS WC SIAIU- OER
EMPLOYERS'LIABILITY
A WCV1001851 10/18/09 10 ANY PROPRIETOR/PARTNER/EXECUTIVE /1 H/1 O E.L.EACH ACCIDENT $ 1,0 0 0 Q Q Q
OFFICER/MEMBER EXCLUDED'? E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000
OTHER
B Pollution ERA614F09 10/12/09 10/12/10 Intl Mold 1,000,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Phase 1 Demolition, Former Chamberlain Mfg, Property Contract # 741 in
Waterloo, IA.
City of Waterloo & Howard R. Green Company are named as additional insureds
for both general and auto liability.
CERTIFICATE HOLDER CANCELLATION
CITY051 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
City of Waterloo IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
715 Mulberry Street
Waterloo IA 50703-5783 REPRESENTATIVES.
AUTHOR NTATIVE
ACORD 25(2001/08)
ACORD CORPORATION 1988