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HomeMy WebLinkAboutEMPIRE ELECTRIC - INSURANCE CERTIFICATE (3)ACORD,M CERTIFICATE OF LIABILITY INSURANCE 01/02/200 ' PRODUCER (303)889-5955 FAX (303)889-5945 Co West Professionals LLC 9025 E. Kenyon, , Suite 312 Y 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 INSURERS: ALLIED INSURANCE INSURER C: INSURER D: INSURER E: nnVFRAGFC 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 IkDD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MWDD/YY) POLICY EXPIRATION DATE (MWDDIYYI 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 a OCCUR MED EXP (Any one person) $ 5,000 B PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY M PROECT LOC J AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X B ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS ACP7502483618 12/31/2006 12/31/2007 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ANY AUTO OTHERTHAN EA ACC $ $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,000 X OCCUR ❑ CLAIMS MADE AGGREGATE $ 2,000,000 B MCT07502483618 12/31/2006 12/31/2007 S $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND 4051499 07/01/2007 07/01/2008 X WC sTLATu- OTH- FR A EMPLOYERu LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ SOU, OOO E.L. DISEASE - EA EMPLOYEE $ 500, 000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500, 000 B OTHER ROrPERTY-SPECIAL FORM MCT07502483618 12/31/2006 12/31/2007 RENTED, LEASED $100,000 INSTALLATION FLOATER $100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins 300 LAPORTE Fort Collins, CO 80521 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, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE /5 ACORD 25 (2001/08) ©ACORD CORPORATION 1988