HomeMy WebLinkAboutADK ELECTRIC CORPORATION - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD
ADKELEL-1 P 07 05/06/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Waterfield Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
44 Union Blvd., Suite 630 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Lakewood CO 80228
Phone:303-716-4750 Fax:303-716-4775
ADK Electric Corporation
ADK Properties, L.
3705 S. Jason
Englewood CO 80110
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INSURERS AFFORDING COVERAGE
NAIC #
INSURERA:
Bituminous Insurance
INSURER B:
Plnnacol Assurance
INSURER C:
National Union Fire Ins of PA
INSURER D:
INSURER E:
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.
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LTR
AUU'
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDDIYY
POLICY EXPIRATION
DATE MMIDDIYY
LIMITS
A
X
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE L'J OCCUR
CLP 3 230 367
07/01/06
07/01/07
EACH OCCURRENCE
$1,000,000
PREMISES (Ea occurence)
$300,000
MED FEXP (Any one person)
$ 10 r 000
PERSONAL &ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
POLICY X PRO LOC
JECT
PRODUCTS-COMP/OP AGG
$2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON-OWNEDAUTOS
CAP 3 506 334
07/01/06
07/01/07
COMBINED SINGLE LIMIT
(Ea accident)
$ 1 QOO 000
r ,
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
C
EXCESSIUMBRELLA LIABILITY
X I OCCUR F-1CLAIMSMADE
DEDUCTIBLE
X RETENTION $ 10 , 0 0 0
9031747
07/01/06
07/01/07
EACH OCCURRENCE
$2,000,000
AGGREGATE
$2,000,000
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY ANY PROPRIETOR/PAR'lNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
S yes, describe under
SPECIAL PROVISIONS below
4079547
10/01/05
10/01/06
X TORY LIMITS ER
E.L. EACH ACCIDENT
$500 000
r
E.L. DISEASE - EA EMPLOYEE
$ SOO, OOO
E.L. DISEASE- POLICY LIMIT
$ 1 , 000 , 000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Project: Bear Creek K-8 (A&P Project #5597), 9601 West Dartmouth Place,
Lakewood, CO 80227. Adolfson & Peterson and Jefferson County School
District No. R-1 are Additional Insured, ATIMA, as regards General Liability
for this project.
CERTIFICATE HOLDER CANCELLATION
CITYF-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City Of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY �N TH INSUR ITS AGENTS OR
PO Box Collins��/'A
Fort lliCO 80522-0580 REPRESENTATIVES.
Fischer, CIC
CORPORATION