HomeMy WebLinkAbout102637 XCEL ENERGY INC - INSURANCE CERTIFICATE (2)Aibbk ®
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
10/10/2014
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 1-612-333-3323
CONTACT Matt Christensen or Dawn DeBuhr
NAME:
Hays Companies
PNC No a 612-333-3323 aC No: 612-373 -7270
80 South 8th Street
ADDRESS: ddebuhrWhayscompanies-com
INSURER(S) AFFORDING COVERAGE
'' NAICt
Suite 700
INSURER A: OLD REPUBLIC INS CO
24147
Minneapolis, MN 55402
INSURED
INSURER e: ENERGY INSURANCH SBRVICES
Xcel Energy, Inc.
Northern State Power Company; Public Service Company of CO
INSURER C
and Southwestern Public Service Co.
INSURER D:
INSURER E:
414 Nicollet Mall 4th Floor
INSURER F:
Minneapolis, MNr55401
COVERAGES CERTIFICATE NUMBER: 41810890 RFVISIDN MIIMRFR-
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
JUM
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYY
POLICY EXP
MM/DD/YYY
LIMITS
A
X
COMMERCIAL GENERALLIABILITY
CLAIMS MADE T OCCUR
X
MWZY59347
11/01/14
11/01/15
EACH OCCURRENCE
$ 3,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
b 3, 000, 000
X
MED EXP (Any one person)
$ 10,000
2MM SIR - SEE BELOW
PERSONAL &ADV INJURY
$ 3,000,000
GEN'L
X
AGGREGATE LIMIT APPLIES PER
POLICY E PRO-
JECT LOC
GENERAL AGGREGATE
$ 20,000,000
,
PRODUCTS - COMP/OP AGG
$ 3,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
MWTB21406
11/01/14
11/01/15
COMBINED SINGLE LIMIT
Ea accident
S 5,000,000
X
ANY AUTO
BODILY INJURY (Per person)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
nt)
f
X
HIRED AUTOS NON -OWNED
X AUTOS
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAR.
OCCUR
EACH OCCURRENCE
$
AGGREGATE
S
EXCESS LAB
CLAIMS MADE
DED RETENTION $
g
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNEWEXECUTIVE
OFFICERIMEMBER E%CLUOED7 a
NIA
MWC11718803
11/01/14
11/01/15
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 2,000,000
E.L. DISEASE- EA EMPLOYE
$ 2,000,000
(Mandatory in NH)
If yes, describe under
DE SCRI PTION OF OPERATIONS below
I
E.I_DISEASE - POLICY LIMIT
S 2,000,000
B
GL Self -Insured Retention
P081425
11/01/14
11/Ol/15
SIR 2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be allachad if more space is required)
Certificate holder is additional insured as respects general liability policy where required by written contract.
City of Fort Collins
Risk management
215 North Mason
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.
AUTHORIZED REPRESENTATIVE
USA
C 1988-2014 ACORD CORPORATION. All rinhtc recPru>d
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
ddebuhr,
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