HomeMy WebLinkAboutADK ELECTRIC ADK PROPERTIES - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID P DATE (MMIDD
ADKELKEL-1 07 O5/06/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Waterfield Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
44 Union Blvd., Suite 630 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Lakewood CO 80228
Phone: 303-716-4750 Fax:303-716-4775 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURERA: Bituminous Insurance
ADK Electric Corporation
INSURER B: PSnnacol Assurance
ADK Properties, LLC . INSURER C: National Union Fire Ine of PA
3705 S. Jason INSURER D:
Englewood CO 80110
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATE MM/DDIYY
DATE MM/DDNY
LIMITS
X
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE •- I OCCUR
CLP 3 230 367
07/01/06
07/01/07
EACH OCCURRENCE
$ 1 , 000 , OOO
-DAVWGA
PREMISES Eaoccurence)
$ 300,000
MED EXP (Any one person)
$ 10 , 000
PERSONAL B ADV INJURY
$ 1, 000 , 000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMB APPLIES PER:
POLICY X JECT PRO LOC
PRODUCTS - COMP/OP AGG
$ 2 , 000 , 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CAP 3 506 334
07/01/06
07/01/07
COMBINED SINGLE LIMIT
(Ea accident)
$ 1OOOO
, , OO
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
AUTO ONLY: AGG
$
$
C
EXCESS/UMBRELLA LIABILITY
X I OCCUR �CLAIMSMADE
DEDUCTIBLE
X RETENTION $ 10 , 000
9031747
07/01/06
07/01/07
EACH OCCURRENCE
s2,000,000
AGGREGATE
$2,000,000
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS'LIABILITY
ANY PROPRIETOR/PAR TNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
4079547
10/01/05
10/01/06
X TORY LIMITS ER
E.L. EACH ACCIDENT
s500,000
E.L. DISEASE - EA EMPLOYEE
$ 500 , 000
E.L. DISEASE -POLICY LIMIT
$ 1 , 000, 000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Project: Bear Creek K-8 (A&P Project #5597), 9601 West Dartmouth Place,
Lakewood, CO 80227. Adolfson & Peterson and Jefferson County School
District No. R-1 are Additional Insured, ATIMA, as regards General Liability
for this project.
trCK I irii.A 1 C nV LUCK
CITYF-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY I I N THV INSUR , ITS AGENTS OR
PO BOX 580 REPRESENTATIVES. V
Fort Collins CO 80522-0580
V. Freeman Fischer, CIC