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HomeMy WebLinkAboutBLS Electrical, Inc - Insurance Certificate 2024 A�" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/16/2024 THIS 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 THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions 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 lieu of such endorsement(s). PRODUCER CONTACT NAME: Leah Borre O McAnally Wilkins Insurance,An Alliant Company HONE FAX 432-685-9317 A/c No):432-685 9399 P.O. Box 60810 Midland TX 79711 ADDRESS: leah@mcanallywilkins.com INSURERS AFFORDING COVERAGE NAIC# License#:15714884 INSURERA: Hartford Fire Insurance Com an 19682 INSURED BLACLAB-01 INSURERB:Twin City Fire Insurance Coma 29459 BLS Electrical, Inc. 9235 Eastman Park Drive INSURERC:Hartford Casualty Insurance Co 29424 Unit 6 INSURER D:Hartford Insurance Company of 38261 Windsor CO 80550 INSURER E:Travelers Property Casualty Co 25674 INSURER F: SIriusP01nt Specialty Insuranc 16820 COVERAGES CERTIFICATE NUMBER:1437598706 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLTYPE OF INSURANCE INSD SUER POLICY NUMBER POLICY EFF IPA POLICY LIMITS LTR WVD A X COMMERCIAL GENERAL LIABILITY 46UEJBBlXUC 12/19/2024 12/19/2025 EACH OCCURRENCE $1,000,000 DAMAGE TO R CLAIMS-MADE [XIOCCUR PREMISES (EaEoccu ence $100,000 MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 POLICY PRO LOC PRODUCTS-COMP/OP AGG $2,000,000 X JECT OTHER: Pollution Liability $Included B AUTOMOBILE LIABILITY 46 UEJEM0938 12/19/2024 12/19/2025 COEaMBINED accident SINGLE LIMIT $1,000,000 X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (par. Per accident X CA9948 X MCS90 $ F X UMBRELLA LIAB X OCCUR 46HHJBB2BMR 12/19/2024 12/19/2025 EACH OCCURRENCE $ X EXCESS LIAB TSX-000704-24 12/19/2024 12/19/2025 CLAIMS-MADE AGGREGATE $ DED I X RETENTION$1 n nnn Each 0cc1A gr ate $$10M/$10M D WORKERS COMPENSATION 46 WEH BBIXUJ 12/19/2024 12/19/2025 PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I i ER Ind.Stop Gap ANYPROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 E Leased/Rented Equipment QT-6304X180949-TIL-24 12/19/2024 12/19/2025 PerOcc/Aggregate $750K/$750K DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) All policies except Workers'Compensation include a blanket automatic additional insured endorsement that provides additional insured status to the certificate holder only when there is a written contract between the named insured and the certificate holder that requires such status. All policies include a blanket automatic waiver of subrogation endorsement that provides this feature only when there is a written contract between the named insured and the certificate holder that requires it. The General Liability policy includes a special endorsement that contains"primary&non-contributory'wording.Policies certified contain 30-day notice of cancellation or material change. Certificate Holder is loss payee with regards to rented/leased equipment as their interest may appear. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Division P O Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 6- L t, ,-- ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD