HomeMy WebLinkAboutTEAM ELECTRIC INC - INSURANCE CERTIFICATE (2)g PSSIa,31uxR
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A ORIOM CERTIFICATE OF LIABILITY INSURANCE OAT/02/2012
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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 policy(les) 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 1-303-534-4567 CONTACT
INA, Inc. - Colorado Division NAME: _ _ FAX
PHONE F
(AJC,NO.ExU:—.- — - JC, No):_-__
1550 17th Street E-MAIL
Suite 600 ADDRESS:___ _ - _ _ __ _ . _._ _
Denver, CO 80202 - --- __. _. INSURER(S)AFFORDINGCOVERAGE _I_ NAICO _
INSURER A: CONTINENTAL WESTERN INS CO 10804
INSURED - _-----_-- - - _- -� - --� _---_-_— INSURERS: PINNACOL ASSUR-----_----_� 41190
m TeaElectric, Inc. - _ _-�--- - ---__ -------------
INSURER C :
1158 South Lipan Street INSURER D.
Denver, CO 80223 INSURER E.
COVERAGES CERTIFICATE NUMBER: 25939453 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 �ADDLSUBR POLICY EFF POLICYE%P
I I
LTRI TYPE OF INSURANCE I POLICY NUYBER MWDOIYYYY MMIDDNYYY LIMIT$
A
GENERAL LABILITY
CWP250475629
03/01/1
03/01/13
EACHOCCURRENCE
g 1,000,000
g COMMERCIAL GENERAL LIABILITY
-DAMAGE TO RENTED
PREMISES (Ea orrueence)_
300, 000
_—_ — CLAIMSANOE I %1. OCCUR
_MEDE%P(Anyoneperson)
_S_-__
S 10, 0Do _
_PERSONAL_& ADV INJURY _
f 1,000,000
GENERALAGG_REGATE
$2,000,000
PRODUCTS COMPIOPAGG
GENL AGGREGATE LIMIT APPLIES PER.
S 2,000,000
I %l PRP
I
POLICY LOC-
A
AUTOMOBILE LABILITY
_
(7WP250475629
COMBINED SINGLE LIMB
(Ea amdent) _ _
i 1,000,000
i
x ANY AUTO
BODILY IWURY(Per Person)
ALL OWNED SCHEDULED
BODILY INJURY (Per accgent)
S
AUTOS _ AUTOS
% % NON -OWNED
PROPERTY DAMAGE
HIRED AUTOS AUTOS
_(Per senders)___
A
%
UMBRELLA LIAR I % OCCUR
CU251264628
03/01/12
03/01/13
EACH OCCURRENCE
$1, 000, 000__
_
$ 11000,000
EXCESS LAB _ CLAIMSMADE_AGGREGATE
-DE
_
$
D RETENTION 0
HE
B
WORNERS COMPENSATION
4078043
03/0111
03/01/13
% WC STATUDTH-
AND EMPLOYERS' LIABILITY YIN
-TORYLMIT$____ER_________-___
ANY PROPRIETORIPARTNEWEXECUTIVE
E.L. EACH ACCIDENT
S 1, 0001 000
OFFICERIMEMBER EXCLUDED? L
NIA
"----
E.L. DISEASE - EA EMPLOYE_
S 1, 000, 000
(MandstogInNH)
DESCRIPTIOyyes, RIPTJOe OMar
DN OF OPERATIONS Cebw
EL. DISEASE - POLICY LIMIT
S1,000,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remade; Schedule, It mom pace Is Required)
Re: All Operations. City of Port Collins is included as Additional Insured on the General Liability policy if required
by written contract or agreement and with respect to work performed by Insured subject to the policy terms and
conditions.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
y of Port Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Box 580 AUTHORQED REPRESENTATIVE //n/%
t Collins, / CO 80522-DODO ( /,#
I USA l
n 1gR8_7M0 AM3Rn C0RPnRATInIU All O.Me meem,ad
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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25939453
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