HomeMy WebLinkAbout109881 DICKINSON ELECTRIC - INSURANCE CERTIFICATE (10)02/11/2013 10:01 FAX 19706636801 ALBRECHT INS a 001
Policy Number: Date Entered: 08/08/2012
acCERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
�,,.. 2/11/2013
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 polmy(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 ICONTACT TERIj1
Northern Co Loraflo Insurance Services L7.0
525 N DENVER
LOVELAND CO 80537
INSURED DICKINSON ELECTRIC INC
11.75 E 2ND ST
LOVEhAND, CC 80537
NAME
i+HONL 970) 622-9734 FAz 970) 663-6801
ADDRESS: terri.ncis@gmail.com
INSURERRa AFFORDING COVERAGE NAIC U
HARPER AUTO -OWNERS INSURANCE COMPANY
INSURER B
INSURER C
INSURER D._
INSURER !
INSURER F
COVERAGES CERTIFICATE NUMBER_ REVISION NUMBER:
THIS IS TO CEP.TIPY THAT Tor POLICIES OF INSURANCI ISIED BFIOVV HAVE HH-N ISSUED 10 LHE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REOUIREMF_N'r, TERM OR CONDITION Of ANY
CONTRACT OR OTHtR DOCUMENT WITH RESPECT
TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PENIAIN, THE INSURANCI AFI OHDED BY
HIT POLICIES DESCRIBED HEREIN IS SUBJECT
TO ALL THE TERMS.
EXCLUSIONS AND CONDIITONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR --- ADDL SUER--
POLICY Err POLICYEXP
LTP TYPE OF INSURANCE INSR WVD. POLICY NUMBER
MMIDDNYYY MMIDOIYYYYt LIMITS
_._ ____.___
GENERAL. LIABILITY _.... _—
I nLllocwRlu Nn
$1,000, 000
A �COMMER4IA UINIIF,I L IABILITY ,104632-74505986-11
19AMI I O7 I N I I D
I8/04/2012 8/04/2011 PRI MISLS (I a...... )
�$ 300, DDD
CLAIMS MARL _ OCCUR
MUD L XP (Ay one person)
I $ 10,000
PERSONALS ADV INJURY
$1,000,000
Of NI RAL!(GRI GA II
I$2,000,000
1 00
GI N I AGCRFGATF I IMI 1 APILit SPtRPRODUCTS
�
COMPIOPAGf
$2,000,13
1 $
POLICY J 01 LOC
AUTOMOBILE
LIABILITY
COMBINED SINGI E LIMIT
(Ea scu0anll
P
A
ANY Al1T0 I.48-505-986-00
8/04/2012
6/04/2011
KINK Y INIPRY Ur prison
1 $1,000,000
nLl.owMu `scar wlID
IYUH YINn1EY(Ior aaaldo"N
$1,000,000
'\
AUTOS BOLUS
- NEo
PRoredrnnnA
$1,000,000
HIRED ALTOS iUTO6 .
(For acge)
UMBRELLA LIAR IH (Ur,
LAU I OCI'URRI NI'I
$
EXCESS LIAS I,IIMSARM
SLOW :GA11
$
DEC RETENTION $
WORKERS COMPENSATION _------�---_
WC START : OIL
ICRY t Of TS 1 R
AND EMPLOYERSLIABILITY YIN I
Ali
-..-..
ANf1'ROPRIETURIPAPNIRT Lt IRA
11 LALHACCRANI
Of I IGk MetMDI P 1 M IIDI 1= NIA
(Mandatory In NH)
[I UINASF EArMPLOYI
If Ye L , l,No antler
DLSCROPI AN OF OPERATIONS helow
I
L I DAFASF POI ICY LIMIT
.I
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IA11W11 ACORD 10t. Additional Remarka Srhrsdule, if
more space ie required)
CERTIFICATE HOLDER 7:S ALSO ADDITIONAL INSURED
CERTIFICATE
CITY OF FORT CCLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
FINANCIAL. SERVICES PURCHASING DIVISION THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN
215 N MAIN SECCND FLOOR ACCORDANCE WITH THE POLICY PROVISIONS.
PO BOX 580
AUTHORIZED REPRESENTATIVE
FORT COLLINS CC B0522
J ALBRECHT ... '
O- 1988-2010 ACORD CORPORATION. All rights
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
Produced i,,in _ Fo,ms D - FI —tP-t e. P ms9o1s ImP—sI", P N11h,ng 800-Zw 1 W]