HomeMy WebLinkAboutEDS ELECTRIC CO - INSURANCE CERTIFICATEACORD'M CERTIFICATE OF LIABILITY INSURANCE
DATE(MMYY)
OS/O8/2009
/2009
PRODUCER
PINNACOL ASSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY
7501 E Lowry Blvd
Denver, CO 80230-7006
AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
INSURED
ED'S ELECTRIC CO
5306 W.C.R. 18
LONGMONT, CO 80504-5430
INSURERA: PINNACOL ASSURANCE
41190
INSURERS
INSURER C:
INSURER D:
INSURER E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADD'L
I
POLICY EFFECTIVE
POLICY EXPIRATION
l
LTR
INSRD
TYPE OF INSURANCE
POLICY NUMBER
DATE(MM/DD/YYYY)
DATE(MM/DD/YYYY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1 OCCUR
PREMISES
MED EXP(Any one person)
-
PERSONAL B ADV INJURY
GEN'L AGGREGATE LIMIT APPLIERS PER.
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
POLICY FI PROJECT P LOC
AUTOMOBILE LIABILITY
-
COMBINED SINGLE LIMIT
ANY AUTO
-
(Ea Accident)
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per person)
BODILY INJURY
HIRED AUTOS
NON -OWNED AUTOS
(Per accident)
PROPERTYDAMAGE
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
OTHER THAN EA ACC
ANY AUTO
AUTO ONLY: AG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
AGGREGATE
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
WC STATU- Ll OTHER
A
EMPLOYER'S LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
543130
04/01/2009
04/01/2010
LIMITS
A
E.LLEACH
CH ACCIDENT
$100,000
OFFICER/MEMBER EXCLUDED?
-
E.L DISEASE- EA EMPLOYEE
$100,000
Ifyes, pleasedescribe under SPECIAL PROVISIONS below
E.L DISEASE- POLICY LIMIT
$500,000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
1154769
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins
PO Box 580
THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Fort Collins CO 80522-0580
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Kelsey Caldwell
ACORD 25(2001/08)
Underwriter ACORD CORPORATION 1988
CERTIFICATE HOLDER COPY
City of Fort Collins
PO Box 580
Fort Collins CO 80522-0580
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.