HomeMy WebLinkAboutTEPA EC LLC - INSURANCE CERTIFICATE (4)CERTIFICATE OF LIABILITY INSURANCE
DATE IMMIDONYYY)
2/28/2014
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 endomement(s).
PRODUCER CONTACT Jennifer Walker
_
Commercial Lines - (719) 592-1177 PHONE - FAX
Wells Fargo Insurance Services USA, Inc. INC. E.ip. Ext: 719-785-8119 INC, No):
877-4054032
ADDRESS: jennifer.j.walker@wellsfargo.com _
5755 Mark Dabling Blvd., Suite 300 _ INSURER( AFFORDING COVRuw NAIce
Colorado Springs, CO 80919-2228 INSURER A; Old Republic Insurance Company 24147
INSURED INSURER B, Travelers Property Casualty Co of America 25674
TEPA EC, LLC
INSURER C :
5045 List Drive INSURER D:
INSURER E
Colorado Springs, CO 80919 INSURER F :
COVERAGES CERTIFICATE NHMRER- 7390213 RFVLQION U[iURFR- s„n hr.tow
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.
_ TYPE OF INSURANCE POLICY EFF `POLICY UP
LTA POLICY MYMSER YMIDDIYYYY YMIDD/VYYY Lm"s
A
X
coYYERcu GENERAL LIANLtrY
CLAIMS -MADE _ X] OCCUR
MWZY 301755
3/1/2014
3/1/2015
EACH OCCURRENCE
i1.000,000
-S 500.000
PREMISES
X
MED EXP( ono parson)
$ 1g000
Primary/Non-contributory
PERSONAL B ADV INJURY
S 1•000•01:10
GENL AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
S 2.000.000
POLICY CI JECT1:1 LOC
PRODUCTS -COMPAIP AGG
S 2,000,000
Employee Benetlls
$ 1,D00,000
OTHER:
A
AUTOMOBILE
LIABaRY
MWTB 301629
3/1/2014
3/1/2015
COMBINED SINGLE LIMIT$
_(EA#=Idard), _..._
1,000,000
X
__..
S
ANY AUTO
BODILY INJURY (Par parson)
AOWNED --SCHEDULED
AUUTOSSAUTOS
BODILY INJIRtY(Parackleft)
$
11
PROPERTY DAMAGE
Par aocwwi
$
NON -OWNED
HIRED AUTOS X AUTOS
It
B
xI
UYBRELLALIAB OCCUR
ZUP-14TS0862-14-NF
3/1/2014
3/1/2015
EACH OCCURRENCE
S 6,000,000
AGGREGATE
$ 5,000,000
EXCESS LUIB l CLNMS-MADE
Is
DED X RETENTIONS 10.000
A
WORKERS CONDENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERAIEMBER EXCLUDED7 ❑N
(Mandatory In NH)
MrA
MWC 30148900
3/1/2014
3/1/2015
PE
X ATUTE E
E.L. EACH ACCIDENT
S 1'00°'0°°
E.L. DISEASE - EA EMPLOYE
$ 1.000.000
SM. deacrlbe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
S 1 000.000
B
Leased/Rented Equipment
Installation Floater
660367M779A
3/1/2014
3/1/2015
$2500D0
$250,000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remade Schedule, may he attached It more span Is required)
Certificate holder is recognized as an additional insured as respects: Contractors License fax:970-224-6134
City of Ft. Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
P.O. Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins CO 805220580
AUTHORIZED REPRESENTATIVE "/ry
9/
The ACORD name and loco are registered marks of ACORD @ 1988-2014 ACORD CORPORATION. All rights reserve)
ACORD 25 (2014/Ot) 1111111111111111111111111111111111111
I I 111111111111111111111111111111111111111111111111111111111