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HomeMy WebLinkAboutEFICIENCY MATTERS - INSURANCE CERTIFICATEACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE 10/11/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JOHN CAESAR (13305) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4025 AUTOMATION WAY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR D-2 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. FORT COLLINS, CO 80525-0000 970-282-7200 FAX: 970-282-7204 INSURERS AFFORDING COVERAGE NAIC # INSURED 5143515 INSURERA: COUNTRY Mutual Insurance Company FOX GREGORY / DBA EFICIENCY MATTERS INSURERB: 2423 TERRY LAKE RD FORT COLLINS, CO 80524 INSURERC: INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD' L R POLICY NUMBER POLICY EFFECTIVE E D POLICY EXPIRATION YYY LIMITS GENERAL LIABILITY ❑ COMMERCIAL GENERAL LIABILITY LJ CLAIMS MADE 0 OCCUR ❑ EACH OCCURRENCE DAMAGE( RENTED PREMISESSEaoccurence MED EXP (Any one person) PERSONAL & ADV I NJURY ❑ GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: Li POLICY ❑ PRO LOC PRODUCTS - COMP/OP AGG A ❑ AUTOMOBILE ■ LIABILITY ANYAUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS AV9069223 8/27/2010 8/27/2011 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 ACC I DENT OTHERTHAN EAACC AUTOONLY: AGG EXCESS/UMBRELLA LIABILITY Ell OCCUR 0 CLAIMS MADE ❑ DEDUCTIBLE RETENTION $ EACH OCCURRENCE AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? [] NO If yes, describe under SPECIAL PROVISIONS below El Yes WC STATU- OTH- ---' T RY L M ❑ E E.L. EACH ACCIDENT E.L. DISEASE'- EA EMPLOYEE E.L. DISEASE- POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS rIULUtK FORT COLLINS UTILITY 700 WOOD STREET FORT COLLINS, CO 80524 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 y AGUKD 25 (ZUU1/U8) ©ACORD CORPORATION 1988 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. AI;UKU 25 (ZUUI/Ut$)