HomeMy WebLinkAboutWRAY ELECTRIC INC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pity Madison, Wisconsin 53783-0001
Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.)
Wray Electric Inc Lonnie David
295 S County Road 29 353 E 27th St
Loveland, CO 80537 Loveland, CO 80538-3203
(970) 612-0865 (003/309)
This certificate Is issued as a matter of information only and confers no rights upon the Certificate Holder.
This certificate does not amend. extend or alter the coverage afforded by the Dolicies listed below.
This is to certify Mat Policies of insurance listed below have been issued to the insured named above for the policy penal 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 Me terms, exclusions, and conditions of such policies.
TYPE OF INSURANCE
POLICY NUMBER
POLICY DATE
LIMITS OF LIABILITY
EFFECTIVE EXPIRATION
(Mo,
(MoDa
(Mo, Day, Yr) Day, Yr)
Homeowners/
Bodily Injury and Property Damage
Mobilehomeowners Liability
Each Occurrence $ ,000
Bodily Injury and Property Damage
Boatowners Liability
Each Occurrence $ ,000
Bodily Injury and Pmperty Damage
Personal Umbrella Liability
Each Occurrence $ ,000
Farm Liability & Personal Liability
Each 0cou.. $ '000
Farm/Ranch Liability
Farm Employees Liability
$ '000
SlaMory NN'000
Workers Compensation and
Each Accident $
Disease - Each Employee $ ,000
Employers Liability t
Disease -Policy Limit $ .000
General Liability
General Aggregate $ 2,000,000
Products- Completed Operations Aggregate $ 2,000,000
❑x Commercial General
Personal and Advertising Injury $ 1,000,000
Liability(occurrence)
05-X72904-Ot-00
07/02/2014
07/02/2015
Each Occurrence $ 1,000,000
❑
Damage to Premises Rented to You $ 100,000
❑
Medical Expense (Any One Person) $ 5,000
Each Occumencett $ .000
Businessowners Liability
Aggregatett $ ,000
Common Cause Limit $ '000
Liquor Liability
Aggregate Limit $ ,000
Automobile Liability
Bodily Injury - Each Person $ 1,000,000
❑ Any Auto
Bodily lrqury - Each Accident $ 1,000,000
❑ All Owned Autos
❑x Scheduled Autos
05-X59500-01-00
07/02/2014
07/02/2015
Property Damage $ 1,000,000
❑ Hired Auto
Bodily Injury and Property Damage Combined $ 0,000
❑ Nonowned Autos
Excess Liability
❑ Commercial Blanket Excess
Each OccumencelAggregate $ .000
Other (Miscellaneous Coverages)
Additional Insured: City of Fort Collins
DESCRIPTION OF OPERATIONS l LOCATIONS / VEHICLES / RESTRICTIONS l SPECIAL ITEMS tThe individual or Farmers ❑ Have
shown as insured elected to
be covered under this policy. ❑ Have not
ttProducts-Completed Operations aggregate
is equal to each occurrence limit and is
included in policy aggregate.
@' CERTIFICATEjHOLDERS;NAMEjANDHADDRESSi„'
�CaA;y,_p: m -, "._CANCELIAtiON ;.". `
City of Fort Collins
LxJ Should any of the above described policies be cancelled before the expiration date
thereof, the company will endeavor to mail -( 30 days) written notice to the Certiricate
PO Box 500
Holder named, but failure to mail such notice shall impose no obligation or liability of any kind
'10
upon the company, its agents or representatives. days unless different number of days
Fort Collins, Co 80525
s"°w"
LJ This canines coverage on the date of Issue only. The above describe p IiUe re
subject to cancellation in conformity with their tens and by the laws of th Istat of i su .
DATE ISSUED
TM R D REpg�SEPIr
E
07/02/2014
Ir/ LL
u
U-201 Ed. 6100 Stock No. 06668 Rev. 7/02