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ELECTRICAL MAINTENANCE AND SERVICE - INSURANCE CERTIFICATE
ACORDM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDO/YYYY) 07/03/2007 Colorado BW Insurance Agency, Inc. 4251 Kipling Ste 190 Wheat Ridge, CO 80033 THIS CERTIFICATE IS ISSUED AS A MATTER OF I ONLY AND CONFERS NO RIGHTS UPON THE CEF HOLDER THIS CERTIFICATE DOES NOT AMEND, INSURERS AFFORDING COVERAGE NAIC # INSURED Electrical Maintenance & Service INSURERA Ohio Casualty Insurance Co. 3178 Nome St. INSURERS Employers Compensation Aurora, CO 80010 INSURER INSURER D INSURER E ,`n%/CDAr=Q m THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDI rION 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 kOD-L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDI POLICY EXPIRATION DATE immfi-I LIMITS GENERAL LIABILITY BH053535634 08/21/2007 08/21/2008 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,00 CLAIMS MADE M OCC UP MED EXP (Anyone person) $ 10,000 A PERSONAL &ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGO $ 2,000,0010 POLICY PRO LOC ECT El AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per acutlen[)- $ _ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO q $ AUTOONLV AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR O CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EIG100946300 08/21/2007 08/21/2008 WCSTATU OTH C1 L IE B EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 100,00 EL DISEASE EAEMPLOYEE$ lOO,OO — R/MEEXCLUDED' _ _ _ If yesdescribe eunder SPECIAL PROVISIONS below EL DISEASE -POLICY LIMIT $ 500,00 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins Attn: Insurance Compliance 281 North College Ave Fort Collins, CO 80524 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 MPOSE OBLI Al OR LIABILITY OF ANY KIND UPON THE INSURER VS G B O RESEN TI ES AUTHORIZED REPRESENTATIVE W Mark RTckahv ACORD 25 (2001/08) FAX: (970)224-6134 ©ACORD CORPORATION 1981