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Home My WebLink AboutCERT OF LIABILITY INSURANCE a> DATE(MMIDDIYYYY) ACORU CERTIFICATE OF LIABILITY INSURANCE 01/04/2010 44.....- THIS CERTIFICATION IS ISSUED AS A MATTE OF INFORMATION IPRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LSB Financial 219 Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Cedar Falls,IA 50613 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ph:319-268-4242 NAIC# Fax 319-268-4211 INSURERS AFFORDING COVERAGE INSURED INSURER A: The Travelers Indemnity Company 25658 Peterson Contractors, Inc. INSURER B. Travelers Property Casualty Company 25674 Reinbeck Motors,Inc. INSURER a The Travelers Indemnity Company of CT 25682 10 Box A The Travelers Indemnity Company 25658 Reinbeck,IA 50669 Blackha Street INSURER D: 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 RPOLIEDUCEFFED DTBE Y PAIPOD YAIMS. RATION LIMITS I LTR INSRD POLICY NUMBER DATE(MMIDD/YY) DATE(MM/DDIW) LTR INSRD TYPE OF INSURANCE GENERAL LIABILITY 1,000,000 07/01/2009 07/01/2010 EACH OCCURRENCE $ DAMAGE TO RENTED 300,000 A X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurence) $ MED EXP(Any one person) $ 10,000 CLAIMS MADE I X I OCCUR X PERSONAL&ADV INJURY $ 1,000,000 Blanket Contractual VTNC078806883PHX09 2,000,000 GENERAL AGGREGATE $ X XCU Coverage Included 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $$ 7 POLICY X JJECOT- LOC AUTOMOBILE LIABILITY 07/01/2009 07/01/2010 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) B X ANY AUTO ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS VTJCAP3510A26ATIL09 X HIRED AUTOS BODILY INJURY $ (Per accident) X NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) AUTO ONLY-EA ACCIDENT $ GARAGE LIABILITY OTHER THAN EA ACC $ ANY AUTO AUTO ONLY. AGG $ EXCESS/UMBRELLA LIABILITY 07/01/2009 07/01/2010 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A X OCCUR CLAIMS MADE VTSM KC U P3510A271 I N DO9 $ $ DEDUCTIBLE 10,000 $ X RETENTION $ WC STATU- OTH- WORKERS COMPENSATION AND 07/01/2009 07/01/2010 X I TORY LIMITS ER C EMPLOYERS'LIABILITY E.L.EACH ACCIDENT $ 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE VTC2EU B9123B85509 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 OFFICER/MEMBER EXCLUDED?If yes,describe under E.L.DISEASE-POLICY LIMIT $ 1,000,000 SPECIAL PROVISIONS below OTHER 07/01/2009 07/01/2010 $ 800,000 Cargo D QT660140D7836TIA09 $ 750,000 Rent/Lease Equipment DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS FOR THE PROJECT DESCRIBED AS FY 2010 RIVER RENAISSANCE TRAIL,CONTRACT ID#07-8155-709,THE CITY OF WATERLOO IOWA IS NAMED AS AN ADDITIONAL INSURED PER WRITTEN CONTRACT REQUIREMENTS. PCI#J3000 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF WATERLOO DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN DEPARTMENT OF ENGINEERING NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL 715 MULBERY STREET IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR WATERLOO,IA 50703 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE _ ACORD CORPORATION 1988 ACORD 25(2001/08) IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statment 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 (2001/08)