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HomeMy WebLinkAbout462200 NEI ELECTRIC POWER ENGINEERING INC - INSURANCE CERTIFICATE (3)ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDPIYY() 8 3 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 endorsemenl(s). PRODUCER CONTACT NAME: PHONE FAX - - AIC No : - - Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 EMAIL Denver CO 80202 ADDRESS: INSURER(S) AFFORDING COVERAGE HAIG# INSURERA:XL Specialty Insurance Co. 7 INSURED INSURER B:Hart ford Insurance Group INSURER C: NEI Electric Power Engineering, Inc. INSURER O: P.O. BOX 1265 Arvada CO 80001 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 336594304 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 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE ADDL INSR SUBR VIVO POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDD LIMITS B GENERAL LIABILITY Y Y 34SBWRV7611 8/l/2011 /l/2012 EACH OCCURRENCE $1, 000, 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $1, 000, 000 CLAIMS -MADE KI OCCUR MED EXP(Any one person) $10, 000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2,000,000 POLICY X PRO- LOG $ B AUTOMOBILE LIABILITY Y Y 34SBWRV7611 8/1/2011 /1/2012 COMBINED sM771700T­ Ea accident 51, aoo, DDo BODILY INJURY (Par person) $ ANY AUTO ALLOWNED SCHEDULED AUAUTOS BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Peraccident $ NON -OWNED H1IRED AUTOS X AUTOS 5 B X UMBRELLA LIAB X OCCUR Y Y 34SBWRV7611 8/1/2011 /1/2012 EACH OCCURRENCE $1, 000, 000 AGGREGATE $1,000, 000 EXCESS LIAB CLAIMS -MADE DED X RETENTION$10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN y 34WEGRX2991 8/1/2011 /1/2012 X WC STATU- OTH- T V I IMIIS E. L. EACH ACCIDENT $1, 000, 000 ANY PROPRIETOWPARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? NIA EL. DISEASE - EA EMPLOYEE $1, 000, 000 (Mandatory In NH) If yes, Oescnbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1, 000, 0 0 a A Professional Liability DPR9691189 8/l/2011 /1/2012 Per Claim $1, coo, 000 Claims Made Annual Aggregate $3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) If required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insured under Umbrella / Excess Liability but only with respect to liability arising out of the Named Insured's work performed on behalf of the certificate holder and owner. This insurance will apply on a primary, non-contributory basis. A Blanket Waiver of Subrogation applies See Attached... City of Ft_ Collins P.O. Box 580 Fort Collins CO 80522 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 ORR_9nin ACr1Rn Crh0Cr1DATInIU All A-kfc ---A ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: LOC #: A`40 O�® ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Van Gilder Insurance Corp. NAMED INSURED NEI Electric Power Engineering, Inc. P.O. Box 1265 Arvada CO 80001 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: General Liability, Automobile Liability, Umbrella/Excess Liability and Workers' Compensation. Limited ractual Liability is included. The Umbrella / Excess Liability policy provides excess coverage over General Liability, Automobile Liability and Employers Liability. aj K. Sen tional Insured: City of Ft. Collins © 2008 ACORD reserved. The ACORD name and logo are registered marks of ACORD