HomeMy WebLinkAboutENCORE ELECTRIC, INC. - INSURANCE CERTIFICATEr.:�...,+:. :
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a !�`C Ro� CERTIFICATE OF LIABlLITY INSURANCE DATE;MMlD�lYYYY)
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE H�LDER. THIS
CERTIFICATE DOES NOT AFFIRMATIYELY OR HEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CaNSTITUTE A CONTRACT BETWEEN 7HE 13SUING INSURER(S}, AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certiflcate holder ia an ADDITIONAL INSURED, the polityjles) must have ADDITIONAL INSURED provislons or be endoned.
If SUBRoGAT10N IS WAIVED, subJact to the terma and condltiona of the pollcy, certaEn pollcies may requlre an endonement. A atatement an
this certiflcate does not confer rl hta to the certiflcate holder in Ileu of such endoraement(s .
PRODUCBR 1-800-267-7756 N�ME:
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E-MAIL
PO BOx 9207 APDRE8S:
INSURERS AFFOApINGCOVERAOE NAIC•
Dea Moinee, Ia 50306-9207 Ik9URERA:ZQRZCH AEiER INS CO 16535
INBURED lMBURflRa: T���B �'AOP C118 CO OF A1�R 3567d
Bacore 8lectric, Inc.
IM9URER C :
7125 W. Jeffereon Jlvenue, Suite d00 tMauaeRo:
IM�URERE:
LakbsvOOd, CO 80235 1N8URERF:
COVERAGES CER7IFICATE NUMBER: 59i243�a REVISION NLIMBER:
TH1S IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THE PQLICY PERIOD
lNDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 70 WHICH THIS
CERTIFICATE MAY BE ISSUED pR MAY PERTAIN, THE iNSURANCE AFFOROED BY THE POL CIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXClIJSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEM REDUCEp BY PAID CLAIMS.
IN8R TypEOFINSURANCE g POLICYNUMBER �OLIDYEFF N UpYEXP LIMRE
LTR
A X COMMERCIALOENERALLIAeIL17Y 6IA3125116 OS/O1/30 05/01/21 �qCHOCCURRENCE f 1,000,000
CLAIMS•MAOE � OCCUR PREMI E$1�Ng.ron�r 1� : 100, 000
MED EXP (M one pemon) f 10, D00
PERSONAL6ADVIkJURY 3 1,000,000
GEN'LAGGREGATELIMI7APPUESPER: GENERALAG(3REGATE : 2.000,000
POLICY �� jE 7 � LOC PRODUCTS - COMPlOP AGG f 1� 000 � OOQ
OTHER: :
A AUTOMOBILELIABILITY 8AP1125117 05/O1J20 05/O1/21 OMBINED IN LELIMIT f 1,000,000
a c dent
R ANY AUTO BOpILY INJURY (Per peroon) i
OWNED SCHEOULED 60DILY INJURY (Par ecddant) {
AUTOS OtJLY AUTQS
g HIRED E NON-0WNED PROPERTYDAMAGE f
AUT0.S ONLY AUTOS ONLY
S
H 1C UMBRELLALUIB � p�CUR 2ITP-16N39815 O1/�j/2Q �S/O1/$1 EqCHOCCURRENCE f z�.00��000
EJ(CE03 LIAB CLAfiAS-MADE AGGREC,ATE f�2, 000, 000
DED RETENTIONt � f
� WORNERSCOMPENSATION 97C113115 OS/O1IZ0 OS/O1/21 x STATUTE ERH
AN�EMPLOYERS'LtA61LRV .�f�
ANWROPRIETORIPARTNEWEXECUTIVE E.L. EACH ACCIDENT = 1, 000� OOO
OFFICERIMEMBEREXCLlf0604 � N7A
{M�nd�tory In NH) E.L. DISEASE -EAEMPLOYEE S 1, 000, 000
li yee, describe uMer 1, 000, 000
DESCRIPTION OF OPERATIONS belaw £.L. DISEASE - POLICY LIMIT =
DEBCRIPTION OF OPERATIONS 1 LOCA710NS! VENICLEa (ACORD 101, Addllloml R�mufu SahWul�, m�y W �ItachN N mon �p�p If nqulrody
R8: RFe 866? Arch Blash enalysia. City of Fort Colline ie an additionnl insurefl on qeneral liability nnd autanobile
liability if required by Mritten contract. if the liability Dolicies are cencelled by the iesuinq comanniea, 30 deya
aotice aill be provided to the certificate holder.
Clty Of FOrt Cpllina
P.O. Box 580
Fore colliaa„ Co 80522
ACORD 25 {20161Q3)
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59126314
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXpIAA710N bATE THEREOF, NO710E WILL BE DELIVEREb IN
ACCORDANCH WfTH THE POLICY PROVISIONS.
AUTHORIZEDREPRESENTATNE
II8A �.Adi7 .L� // �atf�.�GLGr
c�i 1988-2015 ACORD CORPORATION. All �ighta reserved.
The ACORD name and logo ere registered marks ot ACdRD
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