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HomeMy WebLinkAbout460317 BELLA ENERGY INC - INSURANCE CERTIFICATE8/2/2011 3:41 PM FROM: Fax Welsh Insurance Agency TO: 1-9M-221-6182 PAGE: 001 OF 001 ACORO ® CERTIFICATE OF LIABILITY INSURANCE DA 0802//1111Yr) PRODUCER Welsh Insurance Agency, Inc. 4033 Boardwalk Drive, Suite #200 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 Fort Collins, CO 80525 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # Phone (970)206-1810 Fax (970)206-1808 INSURED Bella Energy, Inc. 0�1 INSURER A: Auto Owners Insurance Co. INSURER B: 500 S. Arthur Ave., Suite 400 INSURER C' Louisville, CO 80027-3065 INSURER D: Plnnacol Assurance INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED 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. INSR LTR ADD'L INSRO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDM'I POLICY EXPIRATION DATE IMMIODM'I LIMITS GENERAL LIABILITY EACH OCCURRENCE 1,000,000,00 O COMMERCIAL GENERAL LIABILITY 7472426511 03/15/11 03/15/12 DAMAG PREMISES Ea occurence 300,000.00 MED EXP(Any one person) 10,000.00 DO CLAIMS MADE ❑J OCCUR A Q ❑ PERSONAL &ADV INJURY 1,000,000.00 ❑ GENERAL AGGREGATE 2,000,000,00 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG 2,000,000.00 - ❑ POLICY Q PROJECT ❑ LOC AUTOMOBILE LIABILITY ElANYAUTO 4687884300 07/20/11 07/20/12 COMBINED SINGLE LIMIT (Ea accident) 1,000,000.00 80INJURY (Perr po, person) A ❑ ❑ ALL OWNED AUTOS � SCHEDULED AUTOS © HIREDAUTOS © NON OWNED AUTOS BODILY INJURY (Par accident) ❑ PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY- EA ACCIDENT ❑ ❑ ANVAUTO OTHER THAN EA A00 ❑ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY © OCCUR ❑CLAIMS MADE 4672426500 03/15/11 03/15/12 EACH OCCURRENCE 1,000, 000.00 AGGREGATE 1,000,000.00 A ❑ ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS'LUIBILITY 414272 08/01/11 08/01/12 _ �TORY LIMITS ❑ ORH 500,000.00 O ANY PROPRIETOR/PARTNER/EXECUTIVE E.LEACHACCIDENT 500,000.06 OFFICER/MEMBER EXCLUDED? N If yes, describe under E.L. DISEASE -EA EMPLOYEE 500,000.00 E.L. DISEASE- POLICY LIMIT SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS SOLAR ENERGY CONTRACTOR BLANKET ADDITIONAL INSURED AND WAIVER OF SUBROGATION APPLIES TO GL FOR CERTIFICATE HOLDER. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL CITY OF FORT COLLINS 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO PO BOX 440 THE LEFT, BUT FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY FORT COLLINS, CO 80522-0439 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ff� FAX 221-6782 ACOND zb (zi uim) OF © ACORD CORPORATION 1988