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HomeMy WebLinkAbout125947 PTACEK ENTERPRISES INC DBA BATTERIES PLUS - INSURANCE CERTIFICATEClient#: 33281 BPPTAI ACORDT., CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE DATE 07131/201/2012 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 endomement(s). PRODUCER Molyneaux Insurance, Inc. 100 Kirkwood Blvd. P.O. Box939 Davenport, IA 52805 NAME: CONTACT Penny Wilhelm ?NONE 563 324-1011 No: 563 324-7909 AlG No Eat: AX E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICO The Travelers Indemnity Co. of INSURER A : IY 25666 INSURED Ptacek Enterprises, Inc. dba Batteries Plus INSURERB: The Travelers Indemnity Company 25658 INSURER C: Charter Oak Fire Insurance Comp 25615 1107 W. Drake, Unit E-3 Fort Collins, CO 80526 INSURER 0: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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. I�Tq TYPE OF INSURANCE NSR SY D POLICY NUMBER MMIDDYIYEYYV MM/DD//Y `YYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR 16802289W988 8/0812012 08/08/2013 EACH OECCURRENCE E1000000 PR EMISES EgqRE nenca $300000 MDEXP(Any one person) E5000 PERSONAL If ADV INJURY $1,000,000 GENERAL AGGREGATE E2,000,000 GENT AGGREGATE POLICY LIMIT APPLIES PER: PRO- LOC JECT PRODUCTS - COMPIOP AGG E2,000,000 E B AUTOMOBILE LIABILITY X ANY AUTO ALL OWN ED SCHEDULED AUTOS X H RT DSAUTOS X NON -OWNED AUTOS BA615D3648 8108/2012 08108/2013 COBINEDtSINGLE LIMIT 1,000,000 BODILY INJURY (Per Parson) E BODILY INJURY (Per accident) E PROPERTY DAMAGE Per accident E E B X UMBRELLA UAB EXCESS LIAB X OCCUR CLAIMS -MADE ISFCU1P2061W503 8/0812012 08108/2013 EACH OCCURRENCE E1000000 AGGREGATE E1 00O 000 OED X RETENTION 55000 I E C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECJTIVEY/N OFFICERIMEMBER EXCLUDED? � (Mandatory in NH) If yes, describe uner DESCRIPTION OF OPERATIONS ealow NIA IOUB629D6856 8108/2012 08/08/201 X WCSTATU- OTH- TPR E.L. EACH ACCIDENT S1000000 E.L. DISEASE - EA EMPLOYEE E1 OOOOOO E.L. DISEASE -POLICY LIMIT $1000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aeach ACORD 101, Additional Remark. Schedule, If more apace is requmad) Fort Collins Utilities 700 Wood St. Fort Collins, CO 80521 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 �2r� ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 #S728371M72833 The ACORD name and logo are registered marks of ACORD PMW