HomeMy WebLinkAbout399052 ENERGY LOGIC - INSURANCE CERTIFICATE16. a CERTIFICATE OF LIABILITY INSURANCE
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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 pollcy(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 .. ..
Weedin Agency_, _Inc._
PO Box L
p .s
Berthoud', -CO 00513
CONTACT
NAME'--
kH NoE (970) 532-3131 .: FAX Na,(970) 532-3100
- L - ---
ADDRESS .-. .; .,:.. .
NSUBERII) AFFORDING COVERADE,
NAIC1
INSURERA: AUTO —OWNERS INSURANCE CO
INSURED ENERGY LOGIC, INC.
INSURER B PHILADELPHIA INDEMNITY
INSURER C
525 E COUNTY ROAD HWY 56
INSURERD:
BERTHOUD, CO 80513
INSURER E:
INSURER F
CUVFRAt;FS CFRTIFICATF NIIMRFR RF\/ICIi NIIMRRR
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.
ILTR
TYPE OF INSURANCE
DL
IxaR
aueR
MD
POLICY NUMBER
MWOD)YYYY
I Y X
MMIDDII'YYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$
PREMISES(Es occurrence
$
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE C'OCCUR
MED EXP(Any one person)
$
PERSONAL B ADV INJURY
$;, -
'
GENERAL AGGREGATE
$
. l.
' '- "' - "-
GEN'L AGGREGATE LIMIT APPLIES PER: 1-..;
PRODUCTS-COMPIOP AGG
$
.. POLICY ., PRO-` LOC
JECI
.. ...
�... ,..
$
AUTOMOBILE
LIABILITY .
Ea111 accident)$
BODILY INJURY (Per person)
$
SCHEDULED
AUTOS
BODILY INJURY (Per accident)
$
NON -OWNED
S AUTOS
PR P RTY AMA
Per accidentLIAB
$
L
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
R
CLAIMS-NMDE
RETENTIONS
$
AANY
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
PR0PRIET0RNARTNEltM(ECUTIVE ^I j I
OFFILERIMEMBER UCWDEM �I
IManestory In NMI
MIA
74005353
7/1/11
7/1/12
X WCSTATU- OTH-
TORY LIMITS ' ER
E.L. EACH ACCIDENT
$ 1,000,000
E. L. DISEASE - EA EMPLOYEI
$ 1,000,000
If yea, describe under
DESCRIPTION OF OPERATIONS bi
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
PROFESSIONAL
EACH CLAIM $1,000,000
B
LIABILITY
x
PHSD508009
AGGREGATE $1,000,000
5/15/115/15/12
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
City of Fort Collins
215 N Mason Street, 2nd Floor
PO 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.
ACORD25(2010/05)
C 1988-2010
The ACORD name and logo are registered marks of ACORD
reserved.