HomeMy WebLinkAboutSHELLENBARGER ELECTRIC - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCkHBLIPID L
LL 1
DATE IMMIDDIYY)
12/16/04
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Inc - Ft Collins
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, Sth Floor
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 2226
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
Fort Collins CO 80522-2226
Phone:970-482-7747 Fax:970-484-4165
INSURED
INSURERA: Pinnacol Assurance
INSURER B:
Shellenbarger Electric
Attn: Jean Shellenbarger
INSURER C:
INSURER D:
1306 Harlow Lane
Loveland CO 80537
INSURER E:
COVERAGES
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MMIDD
POLICY EXPIRATION
DATE MMIDD
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
EACH OCCURRENCE
$
FIRE DAMAGE (Any one fire)
$
MED EXP (Any one Person)
$
PERSONAL B ADV INJURY
$
GENERAL AGGREGATE
$
GENL AGGREGATE LIMIT APPLIES PER:
POLICY PROJECT LOC
PRODUCTS - COMP/OP AGG
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per aoddent)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY -EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
a
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
3070581
01/01/05
01/01/06
TORY LIMITS ER
E.L. EACH ACCIDENT
$ 100000
E.L. DISEASE - EA EMPLOYEE
$ 100000
E.L. DISEASE -POLICY LIMIT
$500000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
liGrtrrr-RiMIC IIVLYCR yY IWUIINJRML rN`JVRGU�rR3VRCR LCIrCR: 1..N1\\rGLLN 11VN
FTCCITY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -10_ DAYS WRITTEN
City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Department IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
PO Box 580
Fort Collins CO 80522 REPRESENTATIVES.