HomeMy WebLinkAboutPLATTE RIVER POWER AUTHORITY - INSURANCE CERTIFICATE (3)AC� � DATE (MINlDD/YYYY)
�� CERTlFICATE OF LIABILITY INSURANCE o�r2si2o2a
TFSIS 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 7HE COVERAGE AFFpRDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CON7RACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND7HE CERTiFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIpNAL INSIiRED provisions or be endorsed.
lf SUBROGATIpN IS WAIVED, subject to the lerms and conditlons of the pollcy, certaln pollcies may require an endorsement. A statement on
this certificate does not confer rights to the certiflcate holder In Ileu of such endorsement(sl.
PROOUCER
McGnff Insurance Services, LLC
2000 Inlemalional ?ark Orive
Suite 500
Birmingham, A� 35243
INSURED
Plarie River Power Authoriry
2000 East Horsetooth Road
FoA Coflins, CO 80525-5721
COVERAGES
1-8Q0-476-2211
INsuRER A:Assoc. Elec. 8 Gas Ins. Serv. Ltd
CERTiFICATE NUMBER:AK�YSDUT
REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTEO BELOW t-IAVE BEEN 1SSUED TO THE INSURED NAMED ABOVE FOR TNE POLICY PERIOD
INDICAFED. NOTWITHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHlCH THIS
CEf2TIFICA7E AAAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TliE POLICIES DESCRIBED NEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIdNS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR 7ypE OF INSURANCE ADDL� U8 pOLICY NUMBER MMIDDmFF MMIDOIYYYY LIMITS
L712
COMMERCIAL GENERAL LIABILITY EACN OCCURRENCE $
-6A1�fAGETO �ENTE6--�
CIAIMS-MADE � OCCUR pREMISES {Ea oaunence S
MEO EXP (My me person) S
PERSONN. 8 AON INJURY 5
GEN'L AGGREGATE LiM17 APPLIES PER: GENERAL AGGftEGATE S
POUCY � AR� � LOC PROOUCTS - COMP/OP AGG S
J£CT
OTHER §
AUTOMOBSLE UABILITY COMBINED SINGLE LIMIT
(Ea accidenq _ _�_
ANY AUTO BODiLY INJVRY (Per person) 5
OWNEO SCHEDULED BODILY INJURY {Per ecddenl) S
AUTOS ONLY AUTOS
HIREO NON-OWNED PROPERTY DAMAGE a
AUTOS ONLY AUTOS ONLY Par aoc�deM
S
A UMBRELLA LIAB XL5054913P 12J31J2023 12/3t12024 ti,ppp,ppQ
oCCUR ggregate as Applicable EACH OCCURRENCE S
x EXCE39 LIAB X CLAIMS-MAD£ AGGREGATE S 2,000,000
OEO RETENTIONS S
WORiCER9 COMPENSATION PER OTH-
AND EMPLOYER$' LIA$iLITY Y I N I�
ANY PROPRIETORfPARiNERlEXECVTNE ❑ N 1 A F t. EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED7
(Mandatory In NH) E.t. DISEASE - fA EMPLOI'EE S
If yes, describa under
OESGRIPTION OF UPERATIONS baloW � i F. L.OISEHSE - POLICY LIMiT b
S
E
b
S
DESCRIPTION OF OPERATIOHS ! LOCA71QN8! VEHICIES (ACORD 101, Addltional Ramerks Schedule, mey b� attached I} more space la requfred)
Prootoflnsurance
CERTIFICATE HOLDER
SHOULD ANY UFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
C ry of Fort CWlins
Attn. Plann+ng Department
28 N. Co:lege Avenue
Fort Co'lins, CO 80524
ACORD 25 (2016103)
M/TNORIZED REPRE9ENTATIVE
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