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HomeMy WebLinkAboutLAKESTAR ELECTRIC JAMES MITCHELL - INSURANCE CERTIFICATEACORDIN CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D 9/7/2004004 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wakefield Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 211 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Kiowa, CO 80117 303/621-2180 INSURERS AFFORDING COVERAGE NAIC# INSURED James Mitchell INSURERA: Farmers Union Insurance DBA: Lakestar Electric Inc. INSURER B: 2308 Hagerman St. INSURER C: Colorado Springs, CO 80904 INSURER D: 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 NDDT NERD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDIV/ POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 000 , OOO Ai X COMMERCIAL GENERAL LIABILITY ICLAIMSMADE 1XI OCCUR IICT0348545 09/05/04 09/05/05 PREMISES Eaoccurence $ 50 000 MED EXP(Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000 000 �I GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � PRI- LOC JECT PRODUCTS-COMP/OPAGG $ 2,000,000 ! AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE LIMIT (Ea accident) $ 300,000 BODILY INJURY (Per person) $ ALLOWNEDAUTOS SCHEDULED AUTOS X A HIREDAUTOS I1CT0348545 NON -OWNED AUTOS 09/05/04 09/05/05 BODILYINJURY (Peraccidenq $ PROPERTY DAMAGE (Peraccidenq $ III GARAGE LIABILITY —ANYAUTO AUTO ONLY -EA ACCIDENT $ ' OTHER THAN EA ACC AUTOONLY: AGO $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMSMADE I it EACH OCCURRENCE $ AGGREGATE $ j $ DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY TATU - TORY LIMITS ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? IFyes, describe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE -POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Electrical Contractor CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO1II CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL30 DAYS WRITTEN PO BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL FORT COLLINS, CO 8 0 5 22 - 0 5 8 0 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. FAX 9 7 0- 2 2 4- 613 4 AUTHORIZ RESENTATIVE ACORD25(2001/08) ©AC DCO RATION1988