HomeMy WebLinkAboutCircuitus Energy Solutions, Inc. - Insurance Certificate/-l.ACORD"
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CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE NUMBERCOVERAGES REVISION NUMBER:
2t212025
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANO CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE OOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFOROEO BYTHEPOLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PROOUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: lf the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
lf SUBROGATION lS WAIVED, sublect to the terms and conditions ofthe 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).
32700
41190
44776
INSURER F
l@mileins.com
INSUREO
INSURER E
-5445 105
INSURER(S) AFFORDING COVE RAGE I AIC #
E
n
nceINSURERc:Pin
INsURER o:Sta lnsurance Com
303 239-8807
Srstoen
Sln ranu cce mo
Paul Kalen
14'184
lNsuRER B rownersi lnsurance com
PROOUCER
MHIA, LLC
4704 Harlan St., LJnit 660
Denver, CO 80212
Circuitus Energy Solutions, lnc.
2785 S. Raritan Street
Englewood, CO 80110
INSR
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED EELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO \A+IICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED AY THE POLICIES DESCRIBED H EREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHO\AA MAY HAVE BEEN REDUCED BY PAID CLAIi,{S.
LlMllsryPEOF INSURANCE ADOL SUBR POLICY NUMBER
COMMERCIAL GENERAL LABIUry
cLATMS-rraDE lI ] occuR
PERSONAL & AOV INJURY
A x
2t10t2025 211012026
H
NE TE
PRODUCTS coM
aP-PllqsEGEN L EGA TE l"r TAG
LOCPOLICYRO
ECTJ
1,000,000
3,000,000
300,000
3,000,000
10,000
1,000,000
OAMAGE TO RENTEO
COMBINEO S NGLE LIIVITB 1,000,000
5220055401 2110t202s 2t,tot2026 L BOOILY INJURY (Perpe.s6) S
AUTOMOBILE LIABILITY
x
o!1iNEO
AUTOS ONLY
HIREO
AUTOS ONLY
SCHEDIJLED
AUTOS
NON.O!{NED
AUTOS ONLY
A
DEO
EACH OCCURRENCE
264270 2110t2025 2110t2026 AGGREGATE
RETENTION $
x
s
5,000,000
5,000,000
OCCUR
CLAIMS-IIJIAD E
x
1,000,000E L EACH ACCIOENT4234A77u1120252t,12026
BER EXCLIJDEDz
NH)
M
ET
PROPRIETORFARTNFR/EXECI]TIVF
E L DISEASE. POL CY LIMIT
El-rL I
WORXERS COMPENSATION
AND EMPLOYERS' LIABILITY
r,000,000
't,000,000
D
D
E&O
Pollrtion Liability
MA3741242AEM
M83711242AeM
6t1t2024 6t1t2025
6t112024 6t',v2025
Per occurrence / agg
Per occ. / agg.
3,000,000
1,000,000
OESCRIPiION OF OPERATIONS / LOCATIONS / VEHICLES (ACORo l0l, Addition.l Romarks Schedul., may be .tt.chod il morc spece Is requlrcd)
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins Community Development & Neighborhood
Seryices
281 N College Avenue
Fort Collins, CO 80524
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE wlLL BE DELIVERED IN
ACCORDAT{CE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE---/,/,'?//
ACORD 25 (20r6/03)
264270
UIIBRELT.A UAB
X ExcEss LjaB
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The ACORD name and logo are registered marks ofACORO