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HomeMy WebLinkAboutT AND R ELECTRIC SUPPLY - INSURANCE CERTIFICATE (2)�� �'r CERTIFICATE OF LIABILITY INSURANCE D4/29//DD/YYY1� 04/29/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terns 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). PRODUCER 1-605-336-1090 CONTACT NAME: Holmes Murphy & Assoc -SF PHONE FAX (AIC,No E A/C No): ADDRESS: 5120 S. Solberg Ave PRODUCER Sioux Falls, SD 57109 T M RID INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A : Travelers T & R ELECTRIC SUPPLY CO INC INSURER B INSURERC: PO BOX 180 INSURERD: COLMAN, SD 57017 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 15452327 REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR OF INSURANCE ADDLTYPE INSR SUER POLICPOLICY NUMBER MM/DDY EFF MM%DDY EXP LIMITS A GENERAL LIABILITY 6304383N386 04/30/1 04/30/11 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGEPREMISEST( Ea REoccTNurtEDence)$ 300,000 CLAIMS -MADE Fi-I OCCUR MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1 , 000, 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO LOC $ A AUTOMOBILE X LIABILITY ANY AUTO 8104383N386 04/30/1 04/30/11 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ X NON-OWNEDAUTOS $ $ A X UMBRELLA LIAB X OCCUR CUP4383N386 04/30/1 04/30/11 EACH OCCURRENCE $ 20,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $ 20, 000, 000 DEDUCTIBLE $ $ X RETENTION $ 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? I N / A UB4383N386 - 04/30/1 04/30/11 X Wcsrnru- OETH- LIMITSA E.L. EACH ACCIDENT $ 500 , 000 E.L: DISEASE - EA EMPLOYEE $ 500,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below _ E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Certificate Holder is included as an Addtional Insured as respects General Liability coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 85022 USA xcuscnensr ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD 15452327 Holmes Murphy S Assoc -SF 5120 S. Solberg Ave Sioux Falls, SD 57109 USA City of Fort Collins Purchasing Division PO Box 580 Fort Collins, CO 85022 USA 29:152:7677 IIIIIIIIIIIIIIIIIIIIIItIIIllllllllllllllllllllllllllllllllllll We hope you find this document satisfactory. If you have any questions regarding the content of this certificate, please contact Holmes, Murphy 6 Associates or the Insured, both are listed on the certificate of insurance. NOTICE: This communication is not encrypted and may contain privileged or other confidential information. If you are not the intended recipient or believe that you may have received this communication in error, please reply to the sender indicating that fact and delete the copy you received. In addition, you should not print, copy, retransmit, disseminate or otherwise use this information. Thank you. cc: The data included in this notice and in the attached document is confidential to Ebix BPO and the party responsible for bringing you this information. 1:2 Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877.669.8600