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HomeMy WebLinkAboutPETERSON ELECTRIC LLC - INSURANCE CERTIFICATEACORDO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 05/13/2014 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(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 MOODY INS AGENCY INC 8055 E TUFTS A V E S T E 1000 DENVER CO 80237 CONTACTNAME ALYSSA BUDZISZ PHONE FAX INC, No. E# : 888 793-Ml A/L No.: IBM)974-0297 E-MAIL ADDRESS. SERVICECENTERtbUNITEDFIREGROUP.COM PRODUCER CUSTOMER ID#: INSURERS AFFORDING COVERAGE NAIC # INSURED PETERSON ELECTRIC LLC 2355 CALCITE ST LOVELAND CO 80537-2004 INSURER A: United Fire & CasualtV 13021 INSURER B: INSURER C: INsuFIER D� INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER - 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. INsR LTR I TYPE OF INSURANCE ADDL INSR SUER POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MACE FxIOCCUR N N 0134 60350023 07/07/2014 07/07/2015 EACH OCCURRENCE 1,000, DAMAGE TO RENTED PREMISES Ea occurrence E 100 MED EXP (Anyone person) $ PERSONAL & ADV INJURY $ 1,000,0 GEN'L AGGREGATE LIMIT APPLIES PER. PRO- X POLICY OJECT ❑LOC OTHER: GENERAL AGGREGATE $ 2,000,OOC PRODUCTS COMP/OP AGG $ 2, 000, OOC $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS N N 0134 60350023 07/07/2014 07/07/2015 COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Per rson $ BODILY INJURY Per amiden[ $ X PROPERTY DAMAGE (Per accide" $ $ $ UMBRELLA LAB EXCESS LAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEWMEMBER EXCLUDED? u (MkVory M NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA PER STATUATE OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E. L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES (ACORD 101, Additional Remarks Schedule, H more space Is required) YCRIIrIMMIC RVLYCR bA1N$.CLLAIIUIN CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE PO BOX 580 WITH THE POLICY PROVISIONS. FORT COLLINS CO 80522-0580 AUTHORIZED REPRESENTATIVE 26 (2014/011 The ACORD name and loon are registered marks of ACORD 01999.201A A,L�C_kOi,R/'_C_OORRPORATION_ All rinhte rocwrvwl.