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HomeMy WebLinkAboutTEPA EC LLC - INSURANCE CERTIFICATE (5)^0 30005 Ate^ TO® CERTIFICATE OF LIABILITY INSURANCE DATE 013 12/30/2013 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 pollcy(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 CONTACT Jennifer Walker NAYE; Commercial Lines - (719) 592-1177 _PHONE 719-785-8119 AX e8<0-9032�,NQ_EMI Wells Fargo Insurance Services USA, Inc. E-MAIL ADDRESS: Jennifer ..walker wellsfar o.com 1 9 5755 Mark Dabling Blvd., Suite 300 _ INSURERIS) AFFORDING COVERAGE NAIDF Colorado Springs, CO 80919-2228 INSURER A; Hartford Fire Insurance Company 19682 INSURED INSURER B: St. Paul Fire and Marine Insurance Company 24767 TEPA EC, LLC INSURER a : Travelers Property Casualty Co of America 25674 5045 List Drive INSURER D : INSURER E: Colorado Springs, CO 80919 INSURER F: COVERAGES CERTIFICATE NUMBER: 7096505 REVISION NUMBER: Swe hnlnw 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. INBR AO6L aR POLICY EFF POLICY EXP TINTYPE OFINSUIGNCE POLICY NUMBER MWODIYYYY MWDDIYYYY LIMITS A OENERALLIABILRY M TY X COMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR IX 81 UENOC1773 1/112013 3I1/2014 EACH OCCURRENCE To RENTED --- PREMISE _(E_egcwrrence 5 1,000,000 _— S �,� NED EXP M�orN person S _ 10,000 PERSONALS ADV INJURY $ 1,000.000 Blanket AlNVO5 GENERAL AGGREGATE $ 2,000.000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGO $ 2,000,000 POLICY X PRO- LOC Employee Bene/lla b 1,000,000 A AUTOMOBILE LIABILITY Bl UENOCIT74 111/2013 311/2014 COMBINED SINGLE LIMIT Ea ecodenl 10000W BODILY INJURY (Per Peom) 5 X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(PeracCdent) S PROPERTY DAMAGE Per ear I _ $ HIRED AUTOS NON -OWNED AUTOS Med Pay S5.0D0 B x Hired Physics x $250 Com S5 B X UMBRELLA LAB X OCCUR ZUP-14TS0862-13-NF 1/1/2013 3/1/2014 EACH OCCURRENCE S 5.000,000 AGGREGATE S 5,0D0,000 E%CESS LIAR CLAIMS -MADE DEG I X RETEN ION$ 10.000 S A WORKERS COMPENSATION AND EMPLOYERS•UABILITY YIN ANY PROPRIETORMARTNERIEXECUTNE OFFICERIMEMBER EXCLUDED? ❑N (Mandatory In NH) N/A 81WEOC1772 1IM013 3/1/2014 X I WC STAT1U OTH- RYLIML E.L EACH ACCIDENT $ 1,000,000 E1 DISEASE - EA EMPLOYEE S 1,000,000 IIy 'describe under DESCRIPTION OF OPERATIONS be. E.L. DISEASE -POLICY LIMIT S 1000000 C Leased/Rented Equipment Installation Floater 660367M779A 1/1/2013 3/1/2014 S2110,000 $250,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (AKech ACORD 101, Additional Remarks Schedule, If more spare is required) Certificate holder is recognized as an additional insured as respects. Contractors License fax:970-224-6134 Lgdli Lela N�GYBL.Ja City of Fl. 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 9r The ACORD name and logo are registered marks of ACORD ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 11111111111111111111111EI 111111111111 1EI 1111111111111111111111111 111111111111 •creglAwrdmruo2uxwwos• 30305 CERTIFICATE OF LIABILITY INSURANCE I DATE /30/2(MMID013 / 1230/2 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 certlflcate holder Is an ADDITIONAL INSURED, the pollcy(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 certlflcate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT Jennifer Walker NAME: Commercial Lines - (719) 592-1177 PHONE C, No, Ent). 719-76Fr$11g FAX 877.405-9032 _ _ AK N0: Wells Fargo Insurance Services USA, Inc. EMAIL ennifer. .walker wellsfar o.cem ADDRESS: I J 9 _ 5755 Mark Dabling Blvd., Suite 300 INSURE s AFFORDING COVERAGE NAIC0 Colorado Springs, CO 80919-2228 _ _ INSURER A : Hartford Fire Insurance Company 19682 INURED -INSURERS: St. -Paul -Fire and Marine Insurance Company 24767 TEPA EC, LLC INSURER C Travelers Property Casualty Co of America 25674 5045 List Drive INSURER D : INSURER E Colorado Springs, CO 80919 I INSURER I: COVFRArF3 CFRTIFICATF Nl1MRFR• 7096480 RFVIRION MUMRFR• gnu her 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. INBR TR TYPE OF INSURANCE AD susit POLICY NUMBER POLICY EFF INWoorfyyyl POIJCY EXI omporiyyylLIMITS A as LIABILITY MERCIAL GENERA. LIABILITY CLAIMS-MADEOCCUR %XC5DW1nkeI Bl UENOC1773 1/1/2013 3/1/2014 EACH OCCURRENCE $ _ 1000 noo $ buo,00o $ 10.000 P AGE7 ERo curD MI ESIEnow m MED EXP(My we on) PERSONAL B ADV INJURY $ 1,000,000 AIAVOS GENERAL AGGREGATE $ 21000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 Employee BeneON POLICY X JFCT PRO- LOC $ 1,D00 01110 A AUTOMOBILE LIABILITY 81:UENOC1774 1/1/2013 3/1/2014 COMBINED SINGLE LIMIT (Ea ecnklarl__. __ 1,000.000 BODILY INJURY (Par person) X ANY AUTO $ ALL OWNED SCHEDULED AUTOS AUTOS S BODILY INJURY (Pat acdWnt) PROPERTY DAMAGE PM accident NDN-OWNED HIRED AUTOS AUTOS S No Pay $6,000 S x Hired Physics x $250 Corri B MBRELLA LIAR X OCCUR ZUP-14TON62-13-NF 1/1/2013 3/1/2014 EACHOCCURRENCE B g00Q000 TOXE76i AGGREGATE 3 6,OOD,000 CLAIMS -MADE S 10,000 S A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUIIVE OFFICER/MEMBER EXCLUDED? � (Mandatory In NH) NIA BIWEOC.1772 1/1/2013 3/1/2014 X WCSTATU- 1 E.L. EACH ACCIDENT $ 1.000,0110 E.L.DISEASE-EAEMPLOYEE S 1.000.000 If yas, tlaxcribe under DE SCRIPTION OF OPERATIONS W. - E.L. DISEASE - POLICV WILT S 1 000000 C Leased/Rented Equipment 660367M779A 1/1/2013 3/1/2014 F2e0AOD Installation Floater $250,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHIDLE8 (Al ach ACORD 101, Additional Remarks Schedule, if mre space Is requllNd) Certificate issued as proof of Coverage. FAX: 970.224.6134 CFRTIFICATF NOI nFR CANCFI I ATION Fort Collins Contractor SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins CO 805220580 AUTHORIZED REPRESENTATIVE '/^ 9r The ACORD name and logo are registered marks of ACORD © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 11111111111111111111111111111111 11111111111111111111111111111111 'l:Yaa/A30Nea]1 aN2NSN/aNN'