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HomeMy WebLinkAboutCOUPER ELECTRIC LLC - INSURANCE CERTIFICATE`'� �® CERTIFICATE OF LIABILITY INSURANCE eiz3/2011 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. N 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 CONTACT Austin Nikel NAME: First Mainstreet Insurance, LLC PHONE No, (303)776-5122 Ne): (3o3)776-5495 275 S. Main Street, Suite 100 EMAIL anikel@firstmainstreet. coca ADDRESS: P.O. BOX 847 PRODUCER 00018289 CUSTOMER to p: INSURER(S) AFFORDING COVERAGE NAICM Longmont CO 80502 INSURED INSURERAAuto Owners Insurance Co. 118988 INSURER B:Plnnacol Assurance Couper Electric LLC INSURER C: 1331 Kanemoto Lane INSURERD: INSURER E : Erie CO 80516-6947 INSURER F: COVERAGES CERTIFICATE NUMBER:11/12 Master 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 TYPE OF INSURANCE i Nag 1= POLICY NUMBER MM/DDV XP EFF MNIMG YYYY I LIMITS LTR A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 11 OCCUR 74512183 8/11/2011 8/11/2012 EACH OCCURRENCE DAMAGE TO RENTED PREMISES,(Ea_occurrence) MED EXP Any one person)_ PERSONAL8ADV INJURY $ 1,000,000 $ 300, 000 $ 10,000 $ 1,000,000 GENERAL AGGREGATE Is 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY F7 PRO n LOG PRODUCTS - COMP/OP AGG Is 2,000,000 Is A I AUTOMOBILE X LIABILITY. ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NONOWNED AUTOS 19 4851218300 8/11/2011 8/11/2012 COMBINED SINGLE LIMB (Ea ecciden0 $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY(Per ac;d.t) I $ PROPERTY DAMAGE (Per accident) I$ (Medical payments I$ 5,000 I Additonal Expense I $ 50 UMBRELLA LIAR EXCESS UAB OCCUR CLAIMS -MADE tl EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ I $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY1TQRY ANY PROPRIETORPARTNEREXECUTIVE OFFICER/MEMBER EXCLUDED? (klandalory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4089007 2/1/2012 2/1/2013 WC STATU- �OTH- LIMITS ER E.L. EACH ACCIDENT Is 1,000,000 E. L. DISEASE - FA EMPLOYEES 1,000,000 E.L. DISEASE - POLICY LIMIT I $ 1,000,000 l DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach CORD 101, Additional Remarks Schedule, 8 more space it required) City of Fort Collins 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. AUTHORIZED REPRESENTATIVE 25 Nikel/AUSTIN zak /k,% ©1988-2009 ACORD CORPORATION. All rights reserved. IrDULO(2wwV) 1INV M1 MMU IIYIIIC 011U IVgV dIU [VUlbU lCU Indl RS UI XI VRU