HomeMy WebLinkAboutHYDRO ELECTRIC - INSURANCE CERTIFICATEA D-RD,M CERTIFICATE OF LIABILITY INSURANCE O oz/21zl 2'//2008)
/Doos
PRODUCER (970)679-7333 FAX (970)679-7377 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Ewing -Leavitt Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4025 St Cloud Dr HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Loveland, CO 80538 INSURERS AFFORDING COVERAGE NAIC #
INSURED Hydro Electric LLC INSURER Auto Owners 1898g
PO Box 206 INSURERS Owners 32700
Bellevue, CO 80512 INSURER
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
NSR
ILTR
ADD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTNE
POLICY EXPIRATIONDATE
(MMInD(YYI
DATE IMM/DDrM
03/23/2009
LIMITS
GENERAL LIABILITY
7428991808
03/23/2008
EACHOCCURRENCE
$ 1 000 DD
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTEDPREMISES F,�nmM
$ 300 DD
CLAIMS MADE F�] OCCUR
MED EXP(Any
one person)
$ 10 DD
A
PERSONAL BADVINJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2 DDD OO
GEN L AGGREGATE LIMIT APPLIES PER
PRODUCTS COMP/OPAGG
$ 2,000 DD
X POLICY PECT LOC
AUTOMOBILE
LIABILITY
4628991800
10/04/2007
10/04/2008
COMSINED SINGLE LIMIT
$
ANY AUTO
(Ea awdent)
1,000 DUD
ALL OWNED AUTOS
X
BODILY INJURY
B
SCHEDULED AUTOS
(Per person)
X
HIRED AUTOS
BODILY INJURY
$
X
NON OWNED AUTOS
(Per accident)
PROPERTY DAMAGE
$
(Per ecoldent)
GARAGE LIABILITY
AUTOONLY EAACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
AUTO ONLY AGO
$
E%CESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
E
RETENTION $
$
WORKERS COMPENSATION AND
WC STATU OTH
EMPLOYEFES LIABILITY
E L EACH ACCIDENT
$
ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICERIMFMBER EXCLUDED?E
L DISEASE EA EMPLOYEE
$
If yes describe under
E L DISEASE POLICY LIMIT
$
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Fort Collins
PO Box 580
Fort Collins CO 80522
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 MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES
AUTHORIZED
®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