HomeMy WebLinkAboutKNACKSMITH LLC DBA SMITH ELECTRIC, LLC - INSURANCE CERTIFICATEDATE {MM+DDlYYI'Y)
A�� o� CERTIFICATE OF LIABILITY INSURANCE
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATiON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA7£ HOLOER. THIS
GERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER TFfE COVERAGE AFFORDED BY THE POUCIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PROOUCER, AND THE CERTIFICAT� HOLDER.
IMPORTANT: If the certiiicate holder is an ADDITIONAL INSIfRED, the policy{ies) must have ADDITIONAL INSURED provislons or 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 Iteu of such endorsement(s).
vRoouCER NAME Brianne Danieison, CISR
Flood and Peterson PHONE (g70) 266-7118 A (9701 506-6846
ac No exe : ac No : �
Corporate Ma�ling Address -MA�� gDarnelson�FloodPeterson com
AOORESS.
PO Box 578 INSURER{S)AFFOROINGCOVERAGE NAICi
Greeley CO 80632 iNsuaean: �++'ners Insurance Company 32700
iNSUReo iNsuaER B: P�nnaCo! AssuranCe 41190
Knacksmith LLC iNSURER C :
dba Smdh EleCiriC. LLC MSURER D:
6413 Lynn Drive INSURER E:
FOR COIIInS CO 80525-4117 INSURER F:
COVERAGES CERTIFICATE NUMBER: ��1a1a5s5ai REVISION NUMBER:
THf5 IS 70 CERTIFY T1iAT TFiE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE POLICY PERIOD
INDICATED NOTVNTHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OFHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIHEO HER�IN IS SUBJECT TOALL THE TERMS
EXCLUSIONS AND CONQITIONS OF SUCH POLICIES LIMITS SHOW7�1 MAY HAVE BEEM REDUCED BY PAID CLAIMS
LTR TYPE OF INSURANCE INSD WYO POLICY NUMBER MMfDD MMIOOIYYYY LIMITS
X COMMERCIAL GENERAL LIABIUN gqCH OCCURREkCE S� 000.000
CLAIMS•MAOE � OCCUR PREMISES Ea occurrence g 300,000
MED EXP (Any one person) 5 � O 000
A 194632-74351027-23 06/OS/2023 06105/2024 pERSONAlBADViNJURY 5 � 000.0�0
GEN'LAGGREGATE UMITAPPUES PER GENERALAGGREGATE S 2 000 000
POUCY �X PRa � 2 000.000
JBCT LOC PRODUCTS COMP/OPAGG S
OTIiER S
AUTOM081LE LIABIUTY COMBINED SINGLE LIMIT S 1 000 000
Ea acWenl
X ANY AUTO BODILY INJVRY �.Per person) S
q OwNED SCKEDULED 52-351-027•01 0610512023 06105l2024 BQpIIY INJURY {per acaEent) S
AU7050NLY AUTOS
HIRED NON�OWNE4 PR PERTY DAMA E 5
AUTOS ONLY AUTOS ONLY Per acc�dent
Medical Payments 5 5 000
X UMBRELIA LWB X p�CUR EACH OCCURRENCE 5�,OOO OOO
A EXCESSLIAB C�qIMS�MADE 52-351-Q27-00 06I05l2023 O6/OSIZOZ4 AGGREGP.TE S 1,000000
DEO RETENTION 5 S
WORKERS COMPENSATION X STATVTE EORH
AND EMALOYERS' LIABILITY Y 1 N
ANY PROPRIETORJPARTNERlEXECUT VE E L EACHACCIDENT S ��OOO OOO
B OFFICERIMEMBEREXCLUDED� � MIA 4207853 02101�2024 O2I0112025
(Mandatory in NH) E L DISEASE - EA EMPLOYEE S �•000 000
Ir yes, aescnoe unaer 1,000 000
6ESCRfPTION OF OPERAiIONS celow E.L DISEASE - POLICY LIMIF $
LeasedlRented Equipmenl
A 194632-74a51027-23 06l05'2023 06/0512024 Limit $50 00�
Deductible $500
DESCRIPTION OF OPER4TIONS I LOCAT70NS I VEHICLES {ACORD 107, AtlCNionN RemaAcs Sthedule, may be attaeNeE it moie spate i6 �equi2G)
This certificate is issued as a mafter oi INFORMATiON ONLY and wverages reflected are as ot the date of ssuance
Ciry of Fort Collins
A24 W Mulberry St
SHOULD ANY OF THE ABOVE DESCRIBE6 PO�VCIES 6E CANCELLE� BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH TNE POLICY PROVISIONS.
AUTHORIZED REPRESENTATNE
Fort Collins CO 80521 I �q�,,,t �niP,lSo�,.
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACdRD 25 (2016I03) The ACORD name and logo are registered marks of ACORD