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509412 WARD ALTERNATIVE ENERGY LLC - INSURANCE CERTIFICATE (3)
WARDALT-01 TRAMOS ,acoRO' CERTIFICATE OF LIABILITY INSURANCE 1 on vzola O011112 Y 14 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 endomement(s). PRODUCER Dillingham Insurance P.O. Box 1669 Enid, OK 73702 CONTACT NAME: PHOAIC NE FAX No Eat: (580) 233-2000 ac No), (580) 242-6703 E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC If INSURERA:Mid-Continent Casualty Company 23418 INSURED INSURER B: Artisan and Truckers Casualty Company 10194 INSURER C Ward Alternative Energy, LLC INSURER D 215 West Oak Street, Suite 1000 Fort Collins, CO 80521 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 TR TYPE OF INSURANCE POLICY NUMBER MM /Y/DDYYY /Y MMIDDYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE � OCCUR X 04GL914865 10/12/2014 10/12/2015 PREMISES Eaoccunence $ 100,00 MED EXP (My one person) $ Excluded PERSONAL d ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY[fl PRO- JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER 1 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea aaitlont $ 1,000,00 BODILY INJURY (Per person) $ B %( ANY AUTO X 01898979-2 10/1212014 10/12/2015 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident)$ PROPERTY DAMAGE Per accitlenl $ NON -OWNED HIRED AUTOS AUTOS $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,00 AGGREGATE $ A X Excess LIAB CLAIMS -MADE 04XS188157 1011212014 1011212015 DED X RETENTION$ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE PER OTH- STATUTE ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED' NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below I E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) The City of Fort Collins, its officers, agents and employees are additional insureds as provided by the blanket additional Insured endorsement to the general liability policy and per endorsement added to the automobile policy. City of Fort Collins Attn: Purchasing P.O. 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. AUTHORIZED REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD