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HomeMy WebLinkAboutEMPIRE ELECTRIC - INSURANCE CERTIFICATE (2)ACORDM CERTIFICATE OF LIABILITY INSURANCE 01/02/z6) PRODUCER (303)889-5955 FAX (303)889-5945 Co West Professionals LLC 9025 E. Kenyon, Suite 312 Denver, CO 80237 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Empire Electric, Inc., Etal 10575 W. 120th Ave. Broomfield, CO 80021 INSURERA: Pinnacol Assurance 41190 INSURERB: ALLIED INSURANCE INSURERC: INSURER D: INSURER E: rn%/CDAGCe 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR kDD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMIDDIM POLICY EXPIRATION DATE fMM1DDrYYI LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY MCT07502483618 12/31/2006 12/31/2007 DAMAGE TO RENTED $ 300,000 CLAIMS MADE FX I OCCUR MED EXP (Any one person) $ S,000 B PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,000 BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS ACP7502483618 12/31/2006 12/31/2007 (Per person) B BODILY INJURY $ X HIREDAUTOS X NON-OWNEDAUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,000 X OCCUR ❑ CLAIMS MADE AGGREGATE $ 2,000,00 B MCT07502483618 12/31/2006 12/31/2007 $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND 40SI499 07/01/2006 07/01/2007 X I WCSTATu-oTH- El' EMPLOYERS' LIABILITY E.L. EACH ACCIDENT A $ SOO, ON A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. DISEASE - EA EMPLOYEE $ 500,000 OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER RENTED, LEASED $100,000 TY-SPECIAL FORM B MCT07SO2483618 12/31/2006 12/31/2007 INSTALLATION FLOATER $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CFRTIFICOTF MnLnFR CANCFI I ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Fort Collins BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 300 LAPORTE OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE Ann Pas ue AP ACORD 25 (2001/08) ©ACORD CORPORATION 1988