HomeMy WebLinkAbout399052 ENERGYLOGIC INC - INSURANCE CERTIFICATE (3)A� oe CERTIFICATE OF LIABILITY INSURANCE
09/18/20114"
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 POLICIE
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 endorsements .
PRODUCER
CONTACT Lockton Affinity, LLC
NAME:
PHONE 800-806-0263 FAX913-652-7599
Lockton Affinity, LLC
E-MAIL
ADDRESS:
P.O. Box 410679
INSURERS AFFORDING COVERAGE
NAIL
Kansas City, NO 64141-0679
INSURER A: Hartford Casualty Insurance Company
29424
INSURED
EnergyLogic, Inc.
INSURER B
PO Box N
INSURER C
INSURER D:
525 E Cty Rd (Hwy 56)
Berthoud, CO 80513
INSURER E
INSURER F
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO
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 TERM
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCE
ADDL
SUER
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MMID
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
�
CLAIMS -MADE 11 1 OCCUR
x
37SBAAR6056-08
10/20/2014
10/20/2015
EACH OCCURRENCE
$ 2,000,000
DAMAGE TO RENTED PREMISES
PREMI a occurrence
$ 000
MED EXP (Any oneperson)
S 10,000
PERSONAL& ADV INJURY
$ 2,000,000
GENERAL AGGREGATE
$ 4,000,000
GEN'L AGGREGATE
POLICY
LIMIT APPLIES
X PRO
JECT
PER
LOC
PRODUCTS - COMPIOP AGO
$ 4,000,000
$
AUTOMOBILE
LIABILITY
ANYAUTO
ALL OWNED SCHEDULEL
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
CEa accidOMBINEDent SINGLE LIMIT
BODILY INJURY (Per person)
S
BODILY INJURY (PerawitlenB
$
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LAB
EXCESS LAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
LED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTI
OFFICER/MEMBER EXCLUDED'
(Mentlstory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
TWOSTATU- OTH-
LIMITS ER
E.L. EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOY
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anech ACORD 101, Additional Remarks Schedule, If more apace Is required)
Certificate Holder is listed as Additional Insured to the General Liability as respects to work par£orsad by Named Insured
per Hartford Policy Form SS 00 08 04 05.
City of Fort Collins
215 N Mason Street
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ACORD CORPORATION. All
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
14713585 990567