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    MT McGregor CF CI Proposal

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    Sukrit Ghorai
    The document is a certificate of liability insurance for Fisher Associates, PE, LS, PC. It lists the types of insurance policies held by Fisher Associates including general liability, automobile liability, umbrella liability, workers compensation, and professional/pollution liability. The certificate also names The Chazen Companies and New York State Office of General Services as additional insureds under the general liability policy for a specific project.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    MT McGregor CF CI Proposal

    Uploaded by

    Sukrit Ghorai
    88 views1 page
    The document is a certificate of liability insurance for Fisher Associates, PE, LS, PC. It lists the types of insurance policies held by Fisher Associates including general liability, automobile liability, umbrella liability, workers compensation, and professional/pollution liability. The certificate also names The Chazen Companies and New York State Office of General Services as additional insureds under the general liability policy for a specific project.

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    Mt McGregor CF CI Proposal

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    The document is a certificate of liability insurance for Fisher Associates, PE, LS, PC. It lists the types of insurance policies held by Fisher Associates including general liability, automobile liability, umbrella liability, workers compensation, and professional/pollution liability. The certificate also names The Chazen Companies and New York State Office of General Services as additional insureds under the general liability policy for a specific project.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    88 views1 page

    MT McGregor CF CI Proposal

    Uploaded by

    Sukrit Ghorai
    The document is a certificate of liability insurance for Fisher Associates, PE, LS, PC. It lists the types of insurance policies held by Fisher Associates including general liability, automobile liability, umbrella liability, workers compensation, and professional/pollution liability. The certificate also names The Chazen Companies and New York State Office of General Services as additional insureds under the general liability policy for a specific project.

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    © All Rights Reserved
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    of 1

    DATE (MM/DD/YYYY)

    CERTIFICATE OF LIABILITY INSURANCE 11/6/2014


    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).
    CONTACT
    PRODUCER
    NAME: Timothy Esler
    PHONE FAX
    Fenner & Esler (A/C, No, Ext): (201)262-1200 (A/C, No): (201)262-7810
    E-MAIL
    467 Kinderkamack Road ADDRESS:
    P. O. Box 60 INSURER(S) AFFORDING COVERAGE NAIC #
    Oradell NJ 07649-0060 INSURER A :Continental Casualty Company 20443 A
    INSURED INSURER B :Continental Insurance Company 35289 A
    Fisher Associates, PE, LS, PC INSURER C :Travelers Casualty & Surety Co. 31194 A+
    135 Calkins Road INSURER D :RLI Insurance Company 13056 A+
    INSURER E :
    Rochester NY 14623 INSURER F :
    COVERAGES CERTIFICATE NUMBER:Master 12-13 ALL POLICIES 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 ADDL SUBR POLICY EFF POLICY EXP
    LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS
    GENERAL LIABILITY X X EACH OCCURRENCE $ 1,000,000
    DAMAGE TO RENTED
    X COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 300,000
    A CLAIMS-MADE X OCCUR B4024251862 11/12/2012 11/12/2013 MED EXP (Any one person) $ 10,000
    X Includes contractual PERSONAL & ADV INJURY $ 1,000,000
    & XCU coverage per policy terms & conditions GENERAL AGGREGATE $ 2,000,000
    GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
    PRO- 50' of the railroad $
    POLICY XJECT LOC Includes work within
    COMBINED SINGLE LIMIT
    AUTOMOBILE LIABILITY X X (Ea accident) $ 1,000,000
    X ANY AUTO BODILY INJURY (Per person) $
    B ALL OWNED SCHEDULED B4025983357 11/12/2012 11/12/2013 BODILY INJURY (Per accident) $
    AUTOS AUTOS
    NON-OWNED PROPERTY DAMAGE $
    HIRED AUTOS AUTOS (Per accident)
    PIP-Basic $

    X UMBRELLA LIAB X OCCUR X X Per project EACH OCCURRENCE $ 6,000,000


    EXCESS LIAB CLAIMS-MADE aggregate applies AGGREGATE $ 6,000,000
    A
    DED X RETENTION $ 10,000 B4025991331 11/12/2012 11/12/2013 $
    WORKERS COMPENSATION X WC STATU- OTH-
    AND EMPLOYERS' LIABILITY
    X TORY LIMITS ER
    Y/N 7/01/2013 11/12/2013
    ANY PROPRIETOR/PARTNER/EXECUTIVE PSW0002002 E.L. EACH ACCIDENT $ 1,000,000
    OFFICER/MEMBER EXCLUDED? N N/A
    D (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000
    If yes, describe under
    DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
    C Professional/Pollution 105335486 11/12/2012 11/12/2013 Per Claim Limit $3,000,000
    Liability Aggregate Limit $3,000,000

    DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
    Additional Insured - The Chazen Companies and New York State Office of General Services as respects
    general liability where required by written contract.
    RE; FA Project No. 11300T; NYSOGS Term Contract for Environmental Engineering Services, Statewide,
    Contract DOS 4993, DOS A352, DOS A016 and DOS 6871

    CERTIFICATE HOLDER CANCELLATION

    SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE


    THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
    ACCORDANCE WITH THE POLICY PROVISIONS.
    The Chazen Companies
    21 Fox Street
    AUTHORIZED REPRESENTATIVE
    Poughkeepsie, NY 12601

    Timothy Esler/JEAN
    ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved.
    INS025 (201005).01 The ACORD name and logo are registered marks of ACORD

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