HomeMy WebLinkAboutLudvik Electric Company - Insurance Certificate ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
8/1/2025 12/29/2023
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 Lockton CompaniesNT CT
8110 E Union Avenue PHONE
Suite 100 E-MAIL
Denver CO 80237
(303)414-6000 INSURERS AFFORDING COVERAGE NAIC#
INSURER A: QBE Insurance Corporation 39217
INSURED Ludvik Electric Company INSURER B: North Pointe Insurance Company 27740
067559 3900 South Teller St. INSURER C: Regent Insurance Company 24449
Lakewood,CO 80235 INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 1559526 REVISION NUMBER: XXXXXXX
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 ADDL SUB POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDD MMI DNYYYJ LIMITS
B X COMMERCIAL GENERAL LIABILITY 175000014 08/01/202 08/01/202E EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE OCCUR S 300,000
MED EXP An one person) $ 5,000
N N PERSONAL&ADV INJURY $ 1,000.000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
POLICY PRO- LOC
JECT PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER: $
B AUTOMOBILE LIABILITY 165000017 08/01/202 08/01/202 Ee accident SINGLE LIMIT S 1,000,000
Ix
ANY AUTO BODILY INJURY(Per person) $ XXXXXXX
OWNED AUTOS ONLY AUTOS BODILY
N N BODILY INJURY(Per accident)S XXXXXXX
HIRED NON-OWNEDAUTOS ONLY X AUTOS ONLY PROacc'Cent AMAGE S XXXXXXX
$ XXXXXXX
A X UMBRELLA LIAB X OCCUR 195000012 08/01/202 08/01/202E EACH OCCURRENCE $ 10,000,000
EXCESS LIAB CLAIMS-MADE N N AGGREGATE S 10,000,000
DED I RETENTION S $ XXXXXXX
WORKERS COMPENSATION XISPTEATUTF
-
C AND EMPLOYERS'LIABILITY Y/N 155000013 08/01/202 08/01/202
ANY PROPRIETOR/PARTNER/EXECUTIVE N/A N E.L.EACH ACCIDENT $ 1,000,000
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1.000.000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
RE:Contractor's License
CERTIFICATE HOLDER CANCELLATION See Attachments
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
1559526 AUTHORIZED REPRESENTATIVE
City of Fort Collins
Bldg.Inspection Office
PO Box 580,300 Laporte Ave.
Fort Collins,CO 80522 � _ C'�
c 988-20 rig is reserve
ACORD 25(2016103) The ACORD name and logo are registered marks of ACORD