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Home My WebLink About335876 ICE ENERGY LLC - INSURANCE CERTIFICATEACORL7�' CERTIFICATE OF LIABILITY INSURANCE D01/21/20N11D/vYYY) 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 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). PRODUCER Marsh USA, Inc. 1166 Avenue of the Americas New York, NY 10036 CONTACT NAME: PNONE FAX A/C No E-MAIL ADDRESS: PRODUCER CUSTOMER 10 000000--ACORD-11-12 INSURERS AFFORDING COVERAGE NAIC # INSURED an Great Northern Insurance Company INSURER A : p y 20303 ICE ENERGY, INC. 9351 EASTMAN PARK DR. INSURER B : Federal Insurance Company 20281 INSURER C : WINDSOR, CO 80550 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: NYC-004322064-07 RFVISInN NIIII IRFR- 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MWDDNYYY POLICY EXP MM/DDNYYV LIMITS A GENERAL LIABILITY 371145-91 01/23/2011 01/23/2012 EACH OCCURRENCE $ 1,000,000 MERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR 4—clom PREMSES (Ea occurDAMAGE TO ence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ .1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO 7356-57-55 01/23/2011 01/23/2012 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS ' PROPERTY DAMAGE (Per accident) $ HIRED AUTOS Comp/Coll Deductible $ 500 NON -OWNED AUTOS Physical Damage Limit $ 50,000 B UMBRELLA LIAB X OCCUR 7986-79-91 01/23/2011 01/23/2012 EACH OCCURRENCE $ 3,000;000 AGGREGATE $ 3,000,000 EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / NI. ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N / A - - I WC STATU- I OTH- FR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITY OF FORT COLLINS ATTN:DOREEN PO BOX 580 FORT COLLINS, CO 80521 V NIY <.CLLl1I IV14 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Paul Martelloni U 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD