HomeMy WebLinkAbout325120 PRECISION SERVICE ELECTRIC INC - INSURANCE CERTIFICATEPRECI-3 OP ID: MB
CERTIFICATE OF LIABILITY INSURANCE
DAT08/27DIYYVVI
8127112
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 303-962-0811
Insurance West
405 Urban St, Suite 130 303-962-0817
CONTACT
PAHCONEoNEa, AANo):
E-MAIL
ADDRESS:
Lakewood, CO 80228-1211
Susan V. Freeman Fischer, CIC
l'
INSURER(S) AFFORDING COVERAGE
NAICN
INSURER A: Howard Insurance Company
22357
INSURED Precision Service Electric Inc
PO Box 1866
INSURER B:
Loveland, CO 80539
INSURER C
INSURER D
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 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
LTR
rypE OF INSURANCE
ADDL
SUB
POLICY NUMBER
POLICY EFF
M MIODIYYYY)
POLICY EXP
IMMIDDIYYY`10
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
A
X COMMERCIAL GENERAL LIABILITY
X
34SBQIS9429
09/01112
09101/13
PREMISES Eaocm ante
$ 1,000,00
CLAIMS -MADE Fx_1 OCCUR
MED EXP (Any one person)
$ 10,000
PERSONAL 8 ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$ 2,000,000
POLICY PRO LOC
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
accident
1,000,000Ea
8
BODILY INJURY (Per person)
$
A
ANY AUTO
34UECJJ2777
09101112
09/01113
AD SCHEDULED
AUTOSU70S AUTOS
J
BODILY INJURY(Peramdenl)
$
NEO
HIRED AUTOS AUTOSUTOS
PROPERTY DAMAGE
Per accident
S
$
X
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
A
EXCESS LIAB
CLAIMS -MADE
34SBQIS9429
09/01/12
09/01/13
OLD I X I RETENTION$ 10,000
$
A
WORKERS COMPENSATION
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED?
N I A
34WECZG4668
09/01/12
09/01/13
WC STATU- OTH-
X TORY LIMITS X ER
E. L. EACH ACCIDENT
$ 500,000
EL DISEASE EA EMPLOYEE
$ 500,000
(Mandatory in NH)L-YJ
I` yes, ticsc a under
'DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
$ 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, AddNonal Remarks Schedule, if more space Is required)
City of Fort Collins is included as Additional Insured on the General
Liability Policy as required by written contract or agreement and with
respect to work performed by the Insured. All coverage terms, conditions
and exclusions of the policy apply.
CITYF-1
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
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
Susan V. Freeman Fischer, CCC
Qc 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD