HomeMy WebLinkAbout114215 MERIT ELECTRIC INC - INSURANCE CERTIFICATEClient#- 41061
MEREI
ACORD.. CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DO/1'YYY)
O6/29/2011
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
Flood & Peterson ins., Inc.
P. O. Box 578
Greeley, CO 80632
970 356-0123
CONTACT
NAME: Jennifer Winter
PHONE 970 266-7127 A 970 506-6846
C.
No
A/C No at : A/
aoDREss:EJennifer.Winter@fpinsurance.com
CUSTOMER ID a:
INSURER(S) AFFORDING COVERAGE
NAIC It
INSURED
Merit Electric, Inc.
2643 Midpoint Drive, Suite F
Fort Collins, CO 80525
INSURER A: Travelers Insurance Company
INSURER e: Pinnacol Assurance
INSURER C:
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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 15 SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
L R
TIL
TYPE OF INSURANCE
UDDLSUBR
POLICY NUMBER
MWDIVYFYYY
MWOD/VYVY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERALLIABINTV
CLAIMS -MADE 51OCCUR
X PDDed:5,000
4TC03532R691COF1
7/01/2011
07/01/2012
EACH OCCURRENCE
$1000000
PREMISES Eacccurrence
$300000
MED EXP (Any one person)
$10,000
PERSONAL & ADV INJURY
$1,000,000
GENERALAGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO- LOG
PRODUCTS - COMP/OP AGG
$2,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AU OS
AUTOS
Drive Other Car
BA3532R69111CNS
7/01/2011
07/01/2012
COMBINED SINGLE UMIT
(Ea accident)
$1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
1XXX
PROPERTY DAMAGE
(PeraccideriNON-OWNED
$
$
A
X
UMBRELLA LIAR
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
4TSMCUP3532R691T
7/01/2011
07/01/2012
EACH OCCURRENCE
$5000000
AGGREGATE
s5,000,000
DEDUCTIBLE
RETENTION 10000
$
X
$
B
WORKERS COMPENSATION
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/❑N
OFFICER(MEMBER EXCLUDED?
(Mandatory In NH)
Dyyes, describe antler
ESC
DRIPTION OF OPERATIONS below
WA
4070414
7/01/2011
07/01/201
X WCSTATU- TH-
TORY
EL EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
E.L. DIBEABE- POLICY LIMIT
$1,000000
DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (An9ch ACORD 101, Additional Remarks Schedule, If more apace is required)
City of Fort Collins I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins, CO 80522-0580
F'l000t 'r A4_J"S0nJ IA+f✓r &a Je A , TNt.
01988-2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S625636/M625596 JZS