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HomeMy WebLinkAboutEMPIRE ELECTRIC - INSURANCE CERTIFICATE (5)A CQRD,. DATE (MMIDD/VVYY) -- CERTIFICATE OF LIABILITY INSURANCE 12/20/2008 ".a I)DUCER (303) 889-5955 FAX: (303) 889-5945 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION i 'lo West Professionals LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR '025 E. Kenyon, Suite 312 _ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Denver INSURED UMPIRE ELECTRIC INC 1.0575 W. 120TH AVE. !iROOMFIELD, CO 80021 NAIC # 1910( INSURER B: Nationwide Mutual 123787 1 INSURER E: 41190 'OLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING AN 'IREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAI! INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIE..I 'REGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OFINSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIVY POLICY EXPIRATION DATE MMIDD/YY LIMITS GENERAL LIABILITY EACHOCCURRENCE S 1,000,00'! PREMISES PREMISES Ea occurrence S 300, OOC! X COMMERCIALGENER1LUABiLITY A CLAIMS MADE � OCCUR ACPMCT07522483618 12/31/2008 12/31/2009 MED EXP An one erson S 5,000 PERSONAL&ADV INJURY S 1,000,00Cl GENERAL AGGREGATE S 2, 000, 00C1 GEN'LAGGREGATE LIMITAPPLIES PER: PRODl1CTS-COMP/UPA S 2,000,00(' _ POI ICY X PECoi LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $ 1,000,00 BODILY INJURY F? ALL OWNED AUTOS ACPBA7522483618 12/31/2008 12/31/2009 SCHEDULED AUTOS (Per person) S X BODILY INJURY HIRED ALL08 X NON-OVVNLD AUTOS (Per accident) S PROPERTY DAMAGE S Rer accident) GARAGE LIABILITY ry AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $. ANY AN IO S AUTO ONLY: AGG I EXCESS/UMBRELLA LIABILITY EACH QCCI RREN $ 2, 000, 00' 1 1 X OCCUR CLAIMS MADE AGGREGATE S 2,000,00 S jIl g A DEouclual-e ACPMCT07522483618 12/31/2006 12/31/2009 S X RPTFHT'.QN10,000 (J WORKERS COMPENSATION AND X pryl MIT- O--M- EMPLOYERS' LIABILITY EL. EACH ACCIDENT -- S 500,00''_ ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEiR EXCLUDED? 9051999 7/1/2008 7/1/2009 EL.DISEASE -EA EMPLOYEES 500,00' I( yes, describe under EL. DISEASE, POUCYLIMIT S 500,001 _ SPECIAL PROVISIONS below A OTHER INLAND MARINE LEASED ACPMCT07512483618 12/31/2008 12/31/2009 $150,000 SPECIAL -- BORROWED RENTED FORM $500 DED PTION OF OPERAI I()N8/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS W SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fort Collins EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAII 300 LAPORTE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BU'f Fort Collins, CO 80521 — FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ' Ann Pasque/AP A.r;r"n 25 (2001/08) - - - ©ACORD CORPORATION 19,8 I. P "'I (G108J.OSa Page 1 0l2