HomeMy WebLinkAboutJC UTILITY SERVICES LLC - INSURANCE CERTIFICATE� � DATE (MMfDOfYYYY)
�iQ►� Ro' CERTIFICATE OF �IABILITY INSURANCE
04/13/2023
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RlGHTS UPON THE CERTIFICATE HdLDER. THI5
CERTIFICATE DOES NOT AFFfRMATIVELY OR NEGA7IVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLfCIES
BELdW. 7HIS CERTIFlCATE aF INSURANCE DOE5 NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(5), AU7HORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTlF{CATE HOLDER.
lMPORTANT: If the certiflcate holder is an ADDITIONAL INSURED, ihe policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
!f SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on
this certificate does nat confer rights to the ceK{flcate holder in Ileu of such endorsement(s).
PaoouceR Melissa Hansen
All Colorado lnsurance Services Nn�E:
3443 5. Galena 5l. PHONE .{303} 487-St77 �C �:(303) 847-0409
Suite 180 aooRess: melissa.hansen@allcolorado.org
b8f1VAf, CO 80231 INSUR£R(S� AFFORDlNGCOVERAGE NAIC t
tNsu�o �C Utility Services LLC
956 Idalia Si
Aurora, CO 80071
iHsuReRn: Phoenix Insurance Company (The) 25623
i�vsur�R s:�ravelers Property Casualty Company of America 25674
INSURER C :
�OVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN fSSUED TO THE INSURED NAMED ABOVE FOR THE PQLICY PERIOD
INDICATED. NOTWITHSTANDING ANY RE�UIREMENi, TERM OR CONDITION OF ANY CONiRACT OR OTH�R DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN !S SUBJEGT TO ALL FHE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCFi POLICiES. tIMITS SHOWN MAY HAVE BEEN REDUCED BY PAfD CLAIMS.
�ga TYPE OF INSURANCE D BR pOLICY NUMBER P�CY EFF MMiDD �P LIMITS
A � I C0INMERCIALGENERALLIA6lLI7Y �( 4T-CO-1S596118-PHX-21 05l01l2023 0510112024 EpCHOCCURRENCE 5 9,OOQ,O
I CLAIMS-MADE � OCCUR pREMISES Ea accunence 3 � �fl���
GEN't AGGREGATE LIMIT APPLVES PER:
� POLICY jE� LOC
810- i S415268-27-2SG
OSf01l2023 I 05101l2024
MED EXP (Any one parson t S,�Q�
PERSONAL & ADV INJURY t �,OOO,flOO
GENERALAGGREGA7E S 2,000,000
PRODUCTS-COMP/OPAGG S Z,OOO,000
8061LY INJURY (Per persony
BODfLY INJURY (Per ecadenl
B AUfOMOBILE WBIUTY
� /WY AUTO
OWNED SCHEDULED
AUTOSONLY AUTOS
� HIftEO ✓ NON-OWNED
AU705 ONLY AUTOS ON4Y
B UMBRELLALIAB � pCCUR
� EJ(CESS UAB CLAIMS-MADE
WORKERS COMPfiN5A710N
ANG EMPLOYERS' LIABfLITY Y! N
ANYPROPRIETQRIPARTNERIF](ECUTIVE ❑ N!A
OFF I CER/MEMBER EXCL UDED7
(Mandrtory In NH)
If yes, describe under
C UP-7 S715960-21-2S
05101I2023 I 05f01/2024 Ep,CH OCCURRENCE
AGGREGATE
DESCRIPTION OF OPERATIONS 1 LOCATIONS ! VEHICLES �ACORD 101, AddHlonal Rsmarks Schedul�, mey be attsched H more spacs Is raqulred)
Cily oi Fort Collins is Addilional Insured if required by wrilten contract or written agreement as respecis General Liability
R
City of Fort Collins - Building Services
281 tV Collsge Ave.
Fort Collins, CO BD524
CANC
E.L. EACH ACCIDEM'
E.L. DISEASF. - EA FMPL
E.L OfSEASF. - POUCY l
S
S t,000,000
S
5
E
b
s 1,00O,OOU
j 1,��0,�00
S
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SHOULD ANY OP TME ABOVE OESCRIBED POLICIES BE CANCELLED BEFORE
TFlE EXPIRATION DATE TMEREOF, NOTICE WILL BE DELIVEitED IH
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTMOR1g0 REPRESENTATIVE
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