HomeMy WebLinkAboutMERIT ELECTRIC - INSURANCE CERTIFICATE (5)GI lent*: 4T Ub"1 IVI C KC L
ACORD. CERTIFICATE OF LIABILITY INSURANCE 0DATE (MM/D
7/01/05 D/YYYY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURER A: Zurich
Merit Electric, Inc. INSURERB: National Union Fire Insurance
4700 Innovation Dr Suite D-1 NsuRERc: Pinnacol Assurance
Fort Collins, CO 80525-6254 INSURER D:
INSURER E:
COVFRAr.FS
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
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATEYMM/DD/YYE
POLICY
MWDD/YYN
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 51OCCUR
X PD Ded:5,000
CP0375787402
07/01/05
07/01/06
EACH OCCURRENCE
$1 000 000
DAMAGE AGE TO TENTEccuD nce,
$300 000
MED EXP (Any one person)
$10 000
PERSONAL & ADV INJURY
$1 000 OQO
GENERAL AGGREGATE
s2000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY X PROJECT1:1 LOC
PRODUCTS - COMP/OP AGG
$2 000 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEOULEDAUTOS
HIRED AUTOS
NON-OWNEDAUTOS
CP0375787402
07/01/05
07/01/06
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTOONLY: AGG
$
$
B
EXCESS/UMBRELLA LIABILITY
X1 OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 10000
BE9028980
07/01/05
07/01/06
EACH OCCURRENCE
$1 000 000
AGGREGATE
$1 000 000
$
$
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes. describe under
SPECIAL PROVISIONS below
4070414
07/01105
07/01/06
�( WRY LIMITS ER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L. DISEASE - POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS
Fort Collins Light & Power
700 Wood Street
Fort Collins, CO 80525
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 'An DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENT TIVE
40=I0CUA '* A-A.JSO,%J .rNt✓r a+.JGR , .ZfaL.
ACORD 25 (2001/08) 1 of 2 #M318960 JGH O ACORD CORPORATION 1988
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
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