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HomeMy WebLinkAboutBETA ENERGY INC - INSURANCE CERTIFICATE7/22/2010 11:31 AM FROM: Fax Welsh Insurance Agency TO: 1-970-221-6782 PAGE: 002 OF 002 ACOR-IO® CERTIFICATE OF LIABILITY INSURANCE °A07/22/10 PRODUCER Welsh Insurance Agency, Inc. 4033 Boardwalk Drive, Suite #200 Fort Collins, CO 80525 Phone (970)206-1810 Fax (970)206-1808 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY 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 Bella Energy, Inc. 500 S. Arthur Ave., Suite 400 Louisville, CO 80027 INSURER A: Auto Owners Insurance Co. INSURER B: INSURER C: INSURER D: INSURER E: PINNACOL ASSURANCE COVERAGES INSURER F: THE. POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMEDABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. INSR LTR ADD•L INSRD TYPE OF INSURANCE - POLICY NUMBER POLICY EFFECTIVE DATE (MM/DDIYY) POLICY EXPIRATION DATE (MM/DDIYY) LIMITS A ❑ GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS MADE ❑� OCCUR ❑ 7472426510 03/15/10 03/15/11 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTE PREMISES Ea occurence 300,000 MED EXP (Any one person) 10,000 PERSONAL & ADV INJURY 1,000,000 ❑ GENERAL AGGREGATE 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: ❑ POLICY © PROJECT ❑ LOC PRODUCTS - COMP/OP AGG 2,000,000 A ❑ AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ ALL OWNED AUTOS ❑� SCHEDULEDAUTOS HIRED AUTOS NON OWNED AUTOS ❑ 4687884300 07/20/10 07/20/11 COMBINED SINGLE LIMIT (Ea accident) 1,000,000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) ❑ GARAGE LIABILITY ❑ ANY AUTO ❑ AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGG A ❑ EXCESSIUMBRELLA LIABILITY d❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ 4672426500 03/15/10 03/15/11 EACH OCCURRENCE 1,000,000 AGGREGATE 1,000,000 E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER /MEMBER EXCLUDED? If yes, describe under NO SPECIAL PROVISIONS below 4141272 07/20/10 07/20/11 WC STATU- ❑ OTH- TORY LIMITS ER E.L. EACH ACCIDENT 500,000 E.L. DISEASE- EA EMPLOYEE 500,000 E.L. DISEASE- POLICY LIMIT 500,000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS SOLAR ENERGY CONTRACTOR CERTIFICATE HOLDER CANCELLATION CITY OF FORT COLLINS PO BOX 440 FORT COLLINS, CO 80522-0439 FAX 221-6782 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE r _ ___" — t`" .—Y w, © ACORD CORPORATION 1988