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Home My WebLink About116689 BETZ TRANSFORMERS - INSURANCE CERTIFICATEFm:Moody-Valley Insurance, Fax 970-242-1894 To:FW: Betz Transformers Inc., 16:43 08/0311OGMT-06 Pg 02-03 '4 CERTIFICATE OF LIABILITY INSURANCE 8/3/2010 ' PRODUCER (970)243-3421 FAX: (970)242-1894, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Moody -Valley Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 1509 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 604 25 Road Grand Junction CO 81502 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Berkley Regional Specialty 31295 Betz Transformers Inc. INSURER B:Colorado Casualty Insurance 41785 320 Industrial Ave INSURER c: National Union Fire Ins Co PA 19445 wsURERD:Pinnacol Assurance 41190 Olathe CO 81425 INSURER E:Northland Insurance Co rnVFRaRF:4 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 OFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADDI NSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE lDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR GL0012757 1/22/2010 7ED'D DAMAGE TO RENTED PREMISES Ea occurrence $ 100 000 IVIED EXP(My one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,000 RO- LOC X POLICY PIFCT AUTOMOBILE X LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 B ALL OWNED AUTOS SCHEDULED AUTOS BA8566756 1/22/2010 1/22/2011 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ HIRED AUTOS NONOWNEDAUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN . EA ACC $ ANY AUTO $ AUTO ONLY. AGG EXCESS I UMBRELLA LIABILITY X OCCUR CLAIMS MADE EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 C DEDUCTIBLE BE025902302 1/22/2010 1/22/2011 $ $ X RETENTION $ 10,000 D WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? WC STATU- OTH- X T RY LIMIF R E.L. EACH ACCIDENT $ 1 OOO 000 E.L. DISEASE -EA EMPLOYE $ 1,000,000 (Mandatory in NH) It yes, describe under SPECIAL PROVISIONS below 4067927 1/l/2010 1/1/2011 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 E OTHERCargo TN654682 1/22/2010 1/22/2011 $100,000 limit $1,000 ded except DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT SPECIAL PROVISIONS The City of Fort Collins is listed as Additional Insured regarding general liability per Form CG2015, (07/2004). A 10-day notice of cancellation will apply in the 'event of non-payment of premium. %.Mll%.CLLM I IVn1 (970)221-6782 ktourmaschy@fcgov.com SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION The City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Attn : Kathy NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 700 Wood Street PO BOX 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins, CO 80522 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE - ..-- t N Jordan, CRIS/NANJOR -<+ M�Mw cp 14%Pvary 11 V 1 V53-ZUUV ACORU CORPORATION. All rights reserved. INS025 poo9ol) The ACORD name and logo are registered marks of ACORD Fm:Moody-Valley Insurance, Fax 970-242-1894 To:FW: Betz Transformers Inc., 16:43 0810311OGMT-06 Pg 03-03 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 This Certificate of Insurance 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 after the coverage afforded by the policies listed thereon. At-umu to (tuuaiul) INS0251200901> Fm:Moody-Valley Insurance, Fax 970-242-1894 To:FW: Betz Transformers Inc., 16:43 0810311OGMT-06 Pg 01-03 From: Jennifer Watson Sent: Tuesday, August 03, 2010 4:42 PM To: 'ktourmaschy@fcgov.com'; 'Karen Distel' Subject: Betz Transformers Inc., The City of Fort Collins Attn: Kathy, Attached please find the certificate of liability insurance for the above named insured. Thanks & please let me know if I may assist further. Sincerely, Jennifer Watson, CLCS Commercial Lines Coverage Specialist Moody -Valley Insurance Agency, Inc. Account Administrator 970-243-3421 Main 970-248-8309 Direct 970-242-1894 Fax wv,w.MoodyValleylns.com This communication, together with any attachments hereto or links contained herein, is for the sole_ use of the intended recipient (s) and may contain information that is confidential or legally protected. If you are not the intended recipient, you are hereby notified that any review, disclosure, copying, dissemination, distribution or use of this communication is strictly prohibited. If you have received this communication in error, please notify the sender immediately by return e-mail message and delete the original and all copies of the communication, along with any attachments hereto or links herein, from your system.