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HomeMy WebLinkAboutCOUPER ELECTRIC LLC - INSURANCE CERTIFICATE (3)COUPELE-01 MTUSINSKI ACORO" CERTIFICATE OF LIABILITY INSURANCE DAT12/201D/Y 4 9/12/24 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 �j' - C..L r TrueNorth - - PO Box 847 - Longmont, CO 80502 -- " - -- CONTACT ONT CT Tanya Aschenbrenner.. _ - -- Alc Na Est, (303) 776-5122 ac Hal: (303) 776-5495.. - PHONE (=C ADDRESS: TAschenbrenner@truenorthcompanies.com - INSURER(S)AFFORDING COVERAGE NAICM INSURER A: Auto Owners Insurance Company 18988 INSURED INSURER B: Owners Insurance Company 32700 Couper Electric LLC INSURERC: Pinnacol Assurance Company 41190 INSURER D : 1331 Kanemoto Lane Erie, CO 80516.6947 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 rypE OF INSURANCE POUCYNUMBER POLICY EFF MMIDD/Y POLICY EXP MM/DD/YYYY LIMITS A COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-IOCCUR 74068759 10/01/2014 10/01/2015 EACH OCCURRENCE $ 1,000,00 PREMISES AMTr U $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL$ ADV INJURY $ 1,000,0001 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT F7 LOC '.OTHER' - - GENERAL AGGREGATE $ - 2,000,00 PRODUCTS -COMP16P AGG $- 12,000,00 - $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS X AUTOS 48512183M 10/01/2014 10/01/2015 COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ X id P BODILY INJURY (Per accent ( ) $ PROPERTYDAMAGE Per acrid $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ LIED RETENTION$ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED' ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4089007 10/01/2014 10/01/2016 PER OTH. STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remerim Schedule, may be attached N more apace Is mqulmd) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD