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HomeMy WebLinkAboutWHITEHEAD DBA FORT COLLINS ELECTRIC - INSURANCE CERTIFICATEACORD,K CERTIFICATE OF LIABILITY INSURANCE DATE 5/27/2008 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION MARLENE SELOOVER (18246) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1075 W HORSETOOTH RD HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR STE 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW FORT COLLINS CO 80526 0000 970 221 9655 FAX 970 221 1372 INSURERS AFFORDING COVERAGE NAIC # INSURED 0939419 INSURERA COUNTRY Mutual Insurance Company WHITEHEAD GREG / DBA FORT COLLINS ELECTRIC INSURERS 619 W COUNTY RD 66E FORT COLLINS CO 80524 1 INSURERC 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 kDD I POLICY NUMBER POLICYEFFECTIVE POLICYEXPIRATION LIMITS A GENERAL LIABILITY AM7182869 1/23/2008 1/23/2009 EACH OCCURRENCE $1000000 PREMISES Eaoocurence $50000 COMMERCIAL GENERAL LIABILITY _ CLAIMS MADE OCCUR MED EXP(Any one person) $5000 PERSONAL B ADV INJURY $1 000 000 ❑ BUSINESSOWNERS ❑ GENERAL AGGREGATE $2 000 000 GEN L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OPAGG $2000000 POLICY 0 PRO- LOC AUTOMOBILE LIABILITY SINGLE LIMIT ANY AUTO seta tleD ❑ ALLOWNEDAUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIREDAUTOS BODILY INJURY NON OWNED AUTOS (Pareaitlant)ra) PROPERTY DAMAGE (Peraccident) GARAGE LIABILITY ❑ ANVAUTO AUTOONLY EAACCIDENT OTHERTHAN EAACC AUTOONLV qGG EXCESS/UMBRELLA LIABILITY © OCCUR ® CLAIMS MADE EACHOCCURRENCE AGGREGATE ❑ DEDUCTIBLE RETENTION E WORKERS COMPENSATION AND WC STATU ©OTM 01 EMPLOYERS LIABILITY EL EACH ACCIDENT ANY PROPRIETOR/PARTNEWEXECUTIVE EL DISEASE EAEMPLOYEE OFFICERIMEMBER EXCLUDE09 a NfO it yyea describe under O yes SPECIALPROVISIONSbelow EL DISEASE POLICVLIMIT OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS THE 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 10 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 REPRESENTATIVE (2001/08) L /CO✓Y� 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