HomeMy WebLinkAboutTEAM ELECTRIC INC - INSURANCE CERTIFICATE (3)V5luunun
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CERTIFICATE OF LIABILITY INSURANCE
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07/78/2013
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 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-e567
CONTACT
NAME.
INA, Inc. - Colorado Divieion
LFA%LAIG.
C.M W
VVC. No. Enl: NP):
1550 17th Street
E'YAIC ADDRESS: danpemBimecory. com
Suite 600
—
Denver, CO 80202
INSUREf4S(AFFORDINGCOVERAGE
MANU
INSURER A: ro1N@TfAL WESTERN INS CO
1080e
INSURED
INSURER B: PINNACOL ASSUR
e1190
Team Electric, Inc.
INSURER C :
INSURER O:
1158 South Lipan Street
INSURER E:
DeTLyer, CO 80223
INSURER F:
COVERAGES CERTIFICATE NUMBER: 32242812 REVISION NUMBER:
THIS IS TO. CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW RAVE 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.
LTR --
I TYPE Of INSURANCE ADDL SUBRI I POMY EFF POUCY EEP
POLICY MM D YYA]D/YYYY LWR&
A
GENERAL LABaRY
CWP250e75630
03/01/l
03/01/14
EACH OCCURRENCE
3 1,000,000
E COMMERCIAL GENERAL LABILItt
CIAIMSMADE IxI OCCUR
DAMAGTO RENTED e) _
.PREMIEES(Ea rr
MEDEXP (MynPer )
3 300,000
$10,000
$1, 000, 000
PERSONAL& ADV INJURY
_
GENERAL AGGREGATE
$ 2,000,000
_
E
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$2,000,000
PRO,Fr.TI -I LOC
I POLICY I-1
$
A
AUTOMOBLLE UABVTV
CWP250471630
COMBINED SINGLE UNIT
11, 000, 000
$
E ANY AUTO
BODILY INJURY (Pw peeson)
ALL OWNED SCHEDULED
A�� ATTOS
BODILY INJURY (Per Pc rt)
3
E WREO AUTOS E NN�AAUTOS D
-; «OPER�ttwI,hAMAGE
3
3
A
E
UMBRELLA LAB
E
OCCUR
CU251264629
03/01/1
03/01/14
EACH OCCURRENCE
$1,000,000
AGGREGATE
$1,000,000
EXCESS LAB _
CLAIMS -MADE
DED I I RETENTION 30
$
B
WDRNERS COMPENSATION
AND EMPLOYERS LIABILITY VIM
ANY PROIIMETORIPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
MIA
40780e3
03/01/1
03/01/14
E I WGSTATU OTIL
— TORYLIMITS
__ER_
E.L. EACH ACCIDENT
_
$1,000,000
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
(Myy.es-Imwy M NN)
DESCRIPTITIOONN OF OPERATIONS Ie1PR
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
OESCRRTXIM OF OPEMTpNS I LOCATgM81 VEHICLES (Aeac6 ACORD 101, AHaHImW RrnNe 9cAAtluN. H PRM APKI N rpWrM)
Re: All Operation. 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 Inured subject to the policy terms and
conditions.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
of Port Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Box 580 AUTMOMUD REPRESENTATIVE /%
t C011ino, CO 80522-0000 USA { I.
®1988.2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD
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32242812
Y.•:A