HomeMy WebLinkAboutMODELCO ELECTRIC - INSURANCE CERTIFICATE (3)ACORD CERTIFICATE OF LIABILITY INSURANCE CSR BR DATE (MMIDD/YYYY)
MODEL-2 09/18/03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Olson 6 Olson, Ltd. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Distinctive Insurance Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 1467 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Englewood CO 80150
Phone:303-761-0085 Fax:303-788-1817
INSURED
Modelco Electric Inc
12844 E. 116th Court
Henderson CO 80640-9271
I UVCRAIOCA
INSURERS AFFORDING COVERAGE I NAIC #
INSURER A: P1nnacol Assurance
INSURER B:
INSURER C:
INSURER D:
INSURER E:
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.
LTR
rNSRt
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDIYY)
POLICY EXPIRAT10N
DATE (MMIDD/YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
PREMISES (Ea occurence)
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GENERAL AGGREGATE
$
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
1-1 POLICY PROJECT LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON-OWNEDAUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
A
WORKERS COMPENSATION AND
ANY PROPRIETOR/IETORlEMPLOYERCITYPARTNER/EXECUTIVE
4072890
09/01/03
09/01/04
X Twc LIMITS ER
E.L. EACH ACCIDENT
$500000
OFFICERIMEMBER EXCLUDED?
If yes, describe under
E.L. DISEASE - EA EMPLOYEE
$500000
E.L. DISEASE - POLICY LIMIT 1
$ 500000
SPECIAL PROVISIONS below
OTHER
.EXCEPT FOR 10 DAYS FOR
NON-PAYMENT OF PRENIVN
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
CYFTCO2 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 DO SO SHALL
281 N. College Avenue
City of . Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
Ft Collins CO 80522 REPRESENTATIVES.
(2001/08)
1 ACORD