HomeMy WebLinkAboutPOWUR PBC - INSURANCE CERTIFICATEA��� CERTIFICATE OF LIABILITY INSURANCE DATE(MNVDDMlri)
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0111812024
THIS CERTIFICATE IS ISSU�D AS A MA77ER OF INfaRMATION ONLY AND CONFEAS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DpES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE dF INSURANCE DpES NO7 CdNSTITUTE A CONTRACT BETWEEN THE ISBUING 1NSURER{S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFkCATE HOi.DER.
IMPORTANi: If the certlficate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIQNAL 1NSUREQ provistons or bs endorsed. If �
SUBROGATION IS WAIVEO, subject to the terms and conditions o! the policy, certain policies may require an endorsement. A statement on this
certificate does not confer rights to the certiHcate holder in Ileu of such endorsement(s). ��
PRODUCER NOMN��ACT d
a
AOr1 Risk Insurance Services West, Inc. f393� 758-7688 �� (303) 758-9456 d
D811veP CO OifiCe (NC. No. EKq NC. No. : .a
200 clayton Street, Suite 800 E-MAfL Q
Denver CO 80206 USA aDDRESS: _
r;�;.`�
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INSUHED
POwUr p6C
2583 via de la valle
Suite 321c
Del Mar Ca� 92014 USA
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INSURER(S) AFFORDING COV£RAGE NAIC #
INSURERA: TF1e C011tlll@f1td� Insurance Company 35289
iNsuRERa: Colony insurance Company 39993
INSUREfi C:
INSURER 0:
INSURER E:
INSUREH F
REVISION NUMBER:
THIS fS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD �
INDICATED. NOTWITHSiANDING ANY REQUIREMENT, TERM OR CONpITION OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS *"
CEFITIFICATE MAY BE ISSUEO OR MAY PERTRIN, THE �NSURANCE AFFORDED BY THE POIICIES DESCRI6ED HEREIN IS SUBJECT Tp ALL THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. �IM�TS SHOWN MAY HAVE BEEN REDUCEd BY PAID CLAIMS. Limits shown are as r uested
LTR TYPE OF �NSURANCE I�p yJyD POLtCY NUMBEfl MM/DD�YYYY MhVDD.'YYVY LIMI7S
X COMMERCIALGENERALLIASILITY PA��S EACNOCCURRENCE S1,OOO,OOO
CLAIMS•MADE a�;CI.R PREMISES Ea ottunenCe 41Q0 , 000
MED EXP (My one person) S 10 , 000
PERSOMAL 8 ADV INJURY $1, OQO , O00 �
GEN'LAGGREGATELIMRAPPLI£SPER� GENEFALAGGREGATE S3,OOO,OOO �
X POLICY ❑ PR� ❑ LO(; PROOUCTS•COMP/OPAGG S3,OQ0,000 �
JEC7
OTHER oeducobie S SQ , 000 n
AIIrOMOBItE 1IA81LffY COMBINED SINGLE LIMIT �
E i n
ANY AUTO BOOILY INJU RY � Per person � �
Z
OWNED SCHEDULE� BODILY INJURY (Per accidem) a>
AUTOS
HIREOAU�TOS NON•pWNED PROPERTYDAMAGE V
ONLY AUTOS ONLY Per accident —
.�
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UMBRELLALIAB OCCUR EACH OCCURRENCE V
EXCESS LIAB CLAIMS-MADE AGGREGATE
DED RETENTION
A WORKERS COMPENSA710N AND S 1 1 x PER STATUTE O7H�
EMPLOYERS' 11A81LITY y � N A� � Other Stdt@5 �
ANYAROPRIL-TORlPARTNER/[XECUTIVG E.L.EACHACCfDENT SZ,OOO,OOO
A' OFFICEWMEMBERE%CLUDED? � N!A 703653zia7 Q1�Q1�Z024 01�01/2�Z5
(Me�dalory In NFq �p, E.L. DISEASE-EA EMPLOY�E S 1, OOO , O00
If yes, dosc�bo urWer
OESCFlIPTION OF OPEAATIONS bolow E.L. DISEASE•POLICY LIMfT $1, 000, 000 ---
e E8A - Professional Liability vaCES4281806 O1/20/2024 O1/O1/2Q25 Aggregate Limit 3,000,0 0
- primary Claims-Made Each Occurrence �im 51,000,000 �
DESCRIPTION OF OPERATIONS / IOCATIONS I VEHICLES (ACORD 101, Addl[lonsl Remerks Scheduie, mey he etteched if more 9paCe Is required) �
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CERTIFICATE HOLDER CANCELLATION �
SHOULD ANY OF TH£ ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPINATION OATE THEREpF, NOTICE LViLL BE DELIVERED IN ACCORUANCE WITH THE
POLICY PROVISIONS. �L
Ci ty Of FOf't CO11 i n5 AUTMORIT60 REPRESENTATIYE �
Development Review Center '
281 N. College Ave. �� ����� �G�� �,��„ ��
Fort Collins CO 80524 uSA ��
m1988-2015 ACORD CORPORATION. All righis reserved.
ACORD 25 (2816103) The ACORD name and logo are registered marks of ACORD
AC�RO�
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AGENCY CUSTOMER IQ: 570000087114
LOC At:
ADDITI4NAL REMARKS SCHEDULE
Page _ of
AGENCY NAMEDINSURED
Aon Risk Insurance Services west, inc. Powur PBC
POLICY NUMBER
see certificate Number: 570103648580
CARRIEA NAIC CODE
See Certificate Number: 570103648580 EFFECTIVEDATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FQRM,
FQRM NUMBER: ACORD 25 FORM TITLE: Certificate oi Liability Insurance
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER
1NSURER
INSURER
1NSUKER
ADDITIONAL POLICIES If a policy beluw does not include limit information, r�fer to the corresponding policy on the ACURD
certifcate form for policy limits.
vo�icv ro�.rcv
INSR ApDL SUBR POI.fCYNU1�IB�:R Llb1175
LTR T1'PEOFINSUNANCE ��Sp ��,yp EFFF.CTiVE EXNIRAYION
nATB DATE
(AIAIIDDl1'Y\'1'1 (Al!1VDD/YYYl')
OTHER
B contractors Pollution PACEs4281806 O1/20/2024 Ol/OZ/2025 Aggregate 53,0�0,000
Liability Limit
EdCh 51,000,000
Occurrence
ACORD 101 (2008101) �2008 ACORR CORPORATION. Afl rights reeerved.
The ACORU name end iogo ere registered ma►ks oi ACORQ