HomeMy WebLinkAboutMARKS ELECTRIC - INSURANCE CERTIFICATE (2)ACORD, CERTIFICATE OF LIABILITY INSURANCE
07/31I08D/rYYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
2000 South Colorado Blvd
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
Tower One Suite 14000
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
Denver CO 80222
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Marks Electric Inc
INSURER A Travelers Insurance Company
INSURER B Pmnacol Assurance
12295 W 48th Avenue
INSURER C
Wheat Ridge CO 80033
INSURER
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
INSK
LTR
OD
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DDIYY
POLICY EXPIRATION
DATE MM/DDIYY
LIMITS
A
GENERAL
LIABILITY
6803488A9911ND07
09/30/07
09/30/08
EACH OCCURRENCE
$1 QQQ 000
X
DAMAGE TO RENTED
$300Q00
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 7 OCCUR
MED EXP (Any one person)
$5 000
PERSONAL& ADV INJURY
$1 0Q0 QQQ
GENERAL AGGREGATE
s2,000,000
GEN L AGGREGATE LIMIT APPLIES PER
POLICY 7 PED LOG
PRODUCTS COMP/OP AGG
$2 OOO OQO
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
BA3821A35007SEL
09/30/07
09/30/08
COMBINED SINGLE LIMIT
(Ea acmdent)
$1 000 000
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
X
HIREDAUTOS
NON OWNED AUTOS
BODILY INJURY (Per
(Per acc dent)
X
PROPERTY DAMAGE
(Peraccde t)
$
GARAGE LIABILITY
AUTOONLV EAACCIDENT
$
ANY AUTO
OTHER THAN EA ACC
$
$
$1000000
A
EXCESS/UMBRELLA LIABILITY
X OCCUR ❑ CLAIMS MADE
ISMCUP5074W9831ND0
69/30/07
09/30/08
AUTO ONLY AGO
EACH —OCCURRENCE
AGGREGATE
$1 QQQ 000
XIX RETENTION $ 10000
$
B
WORKERS COMPENSATION AND
EMPLOYERS LIABILITY
4062306
08/01/08
08/01/09
X WC STATU OTH
IQRYLIMIIS PH
EL EACH ACCIDENT
$1 000,000
ANY PROPR ETORIPARTNER EXECUTIVE
OFFICERIMEMBER EXCLUDED'
If y s descr be under
E L DISEASE EA EMPLOYEE
$1 000 000
EL DISEASE POLICY LIMIT $1000000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is listed as an Additional Insured as their Interest
may appear
City of Fort Collins
PO Box 580
Fort Collins CO 80522 0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL I_ 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
ACORD 25 (2001108) 1 of 2 1fMd21R17
AUTHORIZED REPRESENTATIVE
��4GN[7� T 0•t..�1Sds..1 .L Aii✓%&-.J A ,L;,Jc
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
ACORD 25S (20011081 0 -so u...�.e.-,