HomeMy WebLinkAbout109881 DICKINSON ELECTRIC - INSURANCE CERTIFICATE (7)11/29/2011 13:31 FAX 19706636801 ALBRECHT INS 001
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ACORDCERTIFICATE OF LIABILITY INSURANCE
A. I`h1I ImIr.01 1
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PlnnaCol Assurance I TC C'FRTIFI A1I I' If ;SURDAC A MA'iTFR OF INIMPMA:TION ONI Y
7501 E Lowry Blvd /+.NI) (;(INFERS Nr) f:IGHTR UPON 7HE (;L H7IFICKTE I1OI t)LR. THIS
fJernlec CO 80240-700€ CIl2EIFICATFI)OFg NUTAINI NU. FXTFIVDORALTERTHE
COVLRFlGE AFPOf,l)Eq EV 1 NE POLICILli f56..p1N.
INSURERS AFFORDING ORDING COVERAGE NAIC#
IN uI n _ Pmnarol AssNrance _ 41190
DII Elec.d v, Ins
1175 E Cnd Jl I I - - - - - _
t..eel and CO 80537 - - - - -
I F
COVERAGES
T4E P-rJLIUEL O INSURE PIt F l I6 TED FELON HAVE BEEN I ASUE U TO 1 II IN„ UR6IJ IJMJLE) ANOVF -t)F T ICi I'OI I(N PERIUD IIJDIGATG�. NO fJY1THSTANDNC
ANY RLOTJ REMENT. TERM OH CONDITION OF ANY CONTHAS7 OR OT -117 R DOCUMMENT WITH RE: PELT I'O V HIt,-1lHIS CERTI H If, ATE MAY BE ISSUED OR
MAY PERTAIN. THE IPISUP:ANF,E A=FORDED F1'Y THE POLY 111 DI `,;(R10E 1) HEREIN IE P,1111ECT TO ALL TS E T ERNE. FXLET £IONL AND CON 01 I IONV OF SUCH
POLICIES I ILIA C SHOWN FAAY NAVE BEFN REDUCED BY PAIL' `AAIR15.
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DESCRIPTION CE OPERATIONS!LOCATIONS/VEHICLESIE%CEUSIONS ADDED BY E
CERTIFICATE HOLDER
City OF L,velHnd FROII lwe
105 W 51h SI
Loveland, CO 80537
RI Y_lUN% P. /Vh�INJI
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TISPECIAL PROVISIONS
CANCELLATION
c Hy II E AN" ()F TI IF ABOVE DE` CRIEED POLI' IFS BF CANCFI I FO HF&IIRE
THE F_XPIP ATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
1,AIL 10 DAY W RRTFN NM ICE TO I HE CERTI -ICATE HOT DER HLIPED TO TsiE
I FF I PH I FAIL h ETO MAIL SIII I NOTICE ` HALL IMF" IFF IRO OBLIGATION OR
LIABILITY OF ANY IUrIII UPON THE I:OIVPANY ITS ACT IM. OR
R.LPPPLfF N T A I Wt I,.
Jeff Funn
ACORD 2N2001108) I Undn.rwriler ACORD CORPORATION 1988
11/29/2011 13:32 FAX 19706636801 ALBRECHT INS U 002
CERTIFICATE HOLDER COPY
Gity Or Loveland Facilities
105 VV 5th St
Loveland, CO 80537
IMPORTANT
If the certificate holder is an ADDITIONAL. INSURED, the policy(ies) must be endorsed. A
statement ou this certificate does not confer rights to the certificate holder in Lieu of such
endorsement(s).
If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy, certain
policies may require au endorsernenl. A statement an this certificate does not confer ricthis
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 represenfative or producer, and the certificate
holder, nor does it affiurtatively or negatively amend, extend or alter the coverage afforded
by the policies listed thereon.
11/29/2011 13:33 FAX 19706636801 ALBRECHT INS U 003
Policy Number.
Dale Entered. 11/29/2011
-
DATE I11
CERTIFICATE F LIABILITY INSURANCE 1
29/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER
THIS
CERTIFICATE DOES NCT 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, fhe policy(ies) Inusf be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may requioe ma endorsement. A statement'. on this certificate does not confer rights to the
certificate holder in lieu of such endorsernengs).
PRODUCER—.
CI NTAC I'
Northern Colorado Insurance Seruioes Lh0
NAME
525 N. Denver Ave.
PHCINE (970762? 9734 FAM..
Enq — I R,, No) (970) 663-6801
_..
EM
EM MAIL
Loveland, Co 80537
ADDRESS:
INSURERiS) AT'ORDING COVERAGE NAIC0
INSURER AUTO OWNERS INSURANCE COMPANY
INSURED DICKINSON ELECTRIC INC
INSURER B:
INSURER C.:
1175 E 2ND ST
INSURER n '.
LOVELAND, CO 80537
INSURIRB:
INSURER r
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CER rIl"Y l"HAT THE POLI CIF_6 OF INSURANC,I I1:,7 I tits TlW I A\/[ IIF1 N ICiiIEU in tllE INoURI D NAMFI) APOVIFOIL ]III I'OIJC1 1'I RIOD
INDIC,IF 1) NO WITHSTANDING ANY PE0I IIRLMENI IE RM OR COLIN11ON 01= ANY CONTRACI OR OTHI H 000UMI FU WIIII R1=AN C1 70 WIIICII IIS
CERTIFICATE MAY 131E ISSlU1) OR MAY I I'RIAIN, III INSURANCE /,IIAPILTII SY I111' '01 CILC OFSCRIFe1) 1ItOFiN IS StMTI CI IO At II -it IIRMS.
EXCLUSIONS AND CONDITION 3 OF SUCH POLICIES. LIMITS SHOWN MAY HAVIF HEF_N REDUCED BY PAID CLAIMS.
INSR. ADDLSUBRI POLICY FEE POLICY EXP
LTR TYPE OF INSURANCE INSR WVDj_ .. POLICY NUMBER .
IMMIDDIYYYY) IMMMPIN YY— LIMITS
-- . _ _
'.. GENERAL NAME I tt
111 I I OF l 11 , 000 , DDN
A x , on1W `1(V[(1 FIT ev IL1211 nT X I104632--74505986-11 06/04/Poll pe/ca/2D) ITM,.c'I 1O tNa 300,000
IIIMISf9 it a IIa) I1'
CLN, Eh, MI�, OLCUh L. ME D(XP fA ,Y o,e Pe ron).. $ 10,000
FYRsoNAI --IN,n 1Ry T1,000, 000
rI NE PAL Air,l.l(, rr_ T2,000,000
I, (Ftt I A((- EG, H PAT I .NPI.IFS PL A 6 ROC] LOTS GOMP/OP AGO I 9,2 , 000 , 000
PODOv Pp Gu
AUTOMOBILE LIABILITY IMIT COMDIPILD SLIT] I
A �X 48-50.5-986 OO US/01/2011 1 ,DU T'INJUPY
AN,Auro �8/04/Poi mom 1:1,000,000
�AT 01AULI I F.lit'Lul11 Ih1il'INJIII (Iq[I, c6'[11) 11,000,000
All J
r NJN OWNILD I I OI FR _Y D MIA(;I
Ip� H1tte J.�JTus J) Is rt �„I,xie,n Im1, 000,000
9
UMBRELLA LIFlB " IIh l( 11 (^411R1�( N('P F
EXCESS LIAR I AIM111 NAIDI „6GR1 (IA1L $
DED 4ErLNFOP
WORKERS COMPENSATION MCSTIUU 01 s I
AND EMPLOYERS' LIADII..ITY YIN ] I oiWi IMIIS EI:
: ANY mnvrPr TOI /I q]1 NI 111[ 113 ITT V1 I I ACH 1Ln0' NT I6
'(JI 1111 WMFIAW II I%(I Ill)lY �.iN/A
(M 1 nmory In NH) I I ON Aal I A I MPLOV I
if yes, sesame under
DESCRIPTION DF OPERATIONS below EL. DISEASE- POLCY LMI
-----
----- .---- .------
DESCRIPI ION OF OPERATIONS I LOCATIONS I VEHICLES (AVI U ACCRA 101, Add, to nel Rena Ns Sclxotluln, If nmrb sPAce Is rc(pJretl)
CERTIFICATE HOLDER IS ADDITIONAL INSURED
FAX:970-2946
CITY OF LOVLLAND bAC1L)TIES
105 W SIR SIT
LOVF.LAND, CO 80537
ATTN: MARK
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL. BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ACORD 25 (2010105)
The ACORD name and logo are
l mlluuel s..Fox..Ho IlIu,"ANY_, ww lol sH..; o, Inp... -...Vel 11 b .. R1111 10�1 Ili!
marks of ACORD
CORPORATION. All rights reserved.