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.