HomeMy WebLinkAbout325120 PRECISION SERVICE ELECTRIC INC - INSURANCE CERTIFICATE (2)PRECI-3 OP ID: MB
,4COR0' CERTIFICATE OF LIABILITY INSURANCE
DAM 01201 YY)
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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 WANED, 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
Freeman Insurance West
405 Urban St, Suite 130
Lakewood, CO 80228.1211
Susan V. Freeman Fischer, CIC
CONTACT
PONE FAX
.303-962-0811 Alc Ne: 303.962-0817
E'NUL
ADDRE
INSURE S AFFORDING COVERAGE
NAIC tl
INSURER A: H.Were Insurance Company
22357
INSURED Precision Service Electric Inc
PO Box 1866
INSURER B:
Loveland, CO 80539
INSURER C
INSURER 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
TYPE OF INSURANCE
ADDL
U
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MMIDD
LIMITS
A
X
COMMERCUILGENERALLIABRITY
EACH OCCURRENCE
f 1,000,00
CLAIMS -MADE OOCCUR
X
34SBOISS429
09/01/2014
09/01/2015
PREMISESEe omurranca
f 1,000,00
MED UP (My we Person)
f 10,00
PERSONAL S ADV INJURY
f 1,000,00
GEHL AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
E 2,000,00
POLICY 1K JECOT LOC
PRODUCTS -COMP/OPAGG
f 2,000,00
E
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,00
X
BODILY INJURY (Per person)
E
A
ANY AUTO
34UECJJ2777
09/01/2014
09/01/2015
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per oddenq
E
PROPERTY DAMAGE
Per accident
f
NON -OWNED
HIREDAUTOS AUTOS
$
X
UMBRELLAUAB
X
OCCUR
EACH OCCURRENCE
f 1,000,00
AGGREGATE
E 1,000,00
A
EXCESS UAB
CLAIMS -MADE
34SBOIS9429
09/01/2014
09/01/2015
DELI I X I RETENTIONS 10.000
f
A
WORKERS COMPENSATION
ANDEMPLOYERTUAINUTY
ANY PROPRIETOR/PARTNER/EXECU-RVE YIN
OFFICERIMEMBER EXCLUDED'! Y�
(Marmtory In NH)
NIA
34WECZG4668
09/01/2014
09/01/2015
PER OTH-
X STATUTE X ER
E.L. EACH ACCIDENT
f 500,00
E.L. DISEASE - EA EMPLOYEq
f 500,00
It yes, des lxf under
DESCRIPTION OF OPERATIONSoeloe
EL.DISEASE -POLICY LIMIT I
S 500,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addlaonal Rem ft ScMdule, may 0e imcbed N ma, spay Is raqulra,l)
City of Fort Collins is included as Additional Insured on the General
Liability Policy as required by written contract or agreement and with
respect to work performed by the Insured. All coverage terms, conditions
and exclusions of the policy apply.
CITYF-1
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTNOIiU1ED REPRESENTATIVE
-Ao
01988-2014 ACORD CORPORATION. All rights reserved
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD