HomeMy WebLinkAboutWINTERS ELECTRIC INC - INSURANCE CERTIFICATEWINTE-4 OP ID: JM
CERTIFICATE OF LIABILITY INSURANCE
D09/22/2014AM Y)
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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(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 endorsemen s .
PRODUCER Phone: 719-590-9990
CONTACT Jonna Hayes
Six & Gevini Insurance, Inc. Fax: 719-590-9992
3630 Sinton Road, Suite 200
P"oNE 719$67�506 FAX, No: 719-590-9992
ac Ne Es
E-MAIL
ADDRESS: jhayes@six-geving.com
Colorado Springs, CO 80907.5034
James L. Bussanich
INSURERS AFFORDING COVERAGE
NAIC0
INSURER A: Auto -Owners Insurance Co.
18988
INSURED Winters Electric Inc
INSURER B: Plnnacol Assurance
41190
139 Winters Dr
Colorado Springs, CO 80907
INSURER C:
NSURER 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
UB
POLICY NUMBER
MMMIDUD EFF
MPMpCYEXP
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CI -AIMS -MADE FxI OCCUR
74195283
10/2412014
10124/2015
EACH OCCURRENCE
$ 1,000,00
PREMISES Ea occurrence
$ 300,00
MED UP (Any one person)
$ 10,00
PERSONAL B ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GENT AGGREGATE
POLICY
LIMIT APPLIES PER.
X PRO LOC
PRODUCTS - COMP/OP AGG
$ 2,000,00
$
A
AUTOMOBILE UABUJTY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS X AUTOS
X HIRED AUTOS X NON -OWNED
AUTOS
HIRED AUTOS �d
4819628300
10124/2014
10124/2015
COMBINED SINGLE LIMIT
Ee..dam
$ 1,000,00
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
$
A
X
UMBRELLA LIAR
EXCESSLwB
X
OCCUR
CLAIMS -MADE
4819628301
10124/2014
10/24/2015
EACH OCCURRENCE
S 1,000,00
AGGREGATE
$ 1,000,00
DED I X I RETENTION $ 10000
1 $
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYOR
ANY PROPRIETORIPARTNERIEXECUTIVEYI"
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
I( yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
118326
10101/2014
10101/2015
X I WCSTATU- I OTH-
F,I.EACH ACCIDENT
$ 11000100
E.L. DISEASE - EA EMPLOYEE
$ 1rDDDroD
E.L. DISEASE -POLICY LIMIT
$ 1.000,00
A
Equipment Floater
74196283
10/24/2014
10/24/2015
Rented 60,00
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (Anach ACORD 101, Additional Romarb Schedule, if more space is required)
Electrical Wiring
City of Fort Collins
PO Box 580,
Fort Collins, CO 80526
CITYFOR
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE ---
ACORD 25 (2010/05)
01988.2010 ACORD
The ACORD name and logo are registered marks of ACORD
All rahts reserved