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MODELCO ELECTRIC - INSURANCE CERTIFICATE
TE ACORQ CERTIFICATE OF LIABILITY INSURANCE D10/0912007) PRODUCER (303) 740-9404 FAX (303) 779-8376 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Gaspar -Jones & Assoc , Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 7100 E Bel1 evi ew #101 HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW P 0 Box 4516 Greenwood Village, CO 80155 INSURERS AFFORDING COVERAGE NAIC # INSURED Modelco Electric Inc INSURER Owners Insurance Co 32700 12844 E. 116th Ct INSURER Henderson, CO 80640 INSURERC NSURER D NSU RER E CIiVFRAFAFS THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDIN 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 ADD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE IMMIDDNY1 POLICY EXPIRATION DATE IMMIDDIYYI LIMITS GENERAL LIABILITY 74970984-07 09/01/2007 09/01/2008 EACH OCCURRENCE S 1,000,000 MERCIAL GENERAL LIABILITY COMMERCIAL PH _DAMAGE TO RENTED S 300,000 C.AIMS MADE E OCCUR 4XCG" MED EXP (Any one person) $ 10,000 A L Pl us PERSONAL & ADV INJURY S 1,000,000 X Hno Auto GENERAL AGGREGATE $ 4,000,000 'a", L AGGREGATE LIMIT APPLIES PER PRODUCTS COMPIOP AGG S 4,000,000 X POLICY F JJECT LOG AUTOMOBILE LIABILITY ANY AUTO 74970984-07 09/01/2007 09/01/2008 COMBINED SINGLE LIMIT (Ea accident) S 1,000,000 BODILY INJURY (Per person) S A ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per acntlenp $ HIRED AUTOS NON OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTOONLY EAACCIDENT S OTHER THAN EA ACC S ANYAUTO S AUTO ONLY AGG EXCESSIUMBRELLA LIABILITY 43970984-01 09/01/2007 09/01/2008 EACH OCCURRENCE 5 1,000,000 X OCCUR O CLAIMS MADE AGGREGATE S 1,000,000 A s $ DEDUCTIBLE 5 RETENTION S WORKERS COMPENSATION AND WC SCRYTATU OTH EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Et EACH ACCIDENT S E L DISEASE EA EMPLOYE $ OFFICER/MEMBER EXCLUDED' Ifyas deccrpe,.nd., SPECIAL PROVISIONS below E L DISEASE POLICY LIMIT S OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CITY OF FORT COLLINS P 0 BOX 580 FT COLLINS, CO 80522 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 REPRESENTATIVES AU I HOWLED REPRESENTATIVE Daniel Hibdon, CPCU, CIC/DH ^' ACORD 25 (2001/08) FAX (970)224-6 ©ACORD CORPORATION 198E