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HomeMy WebLinkAboutFISKE INC DBA FISKE ELECTRIC - INSURANCE CERTIFICATE (4)Cliental: 52372 FISELI ACORDn., CERTIFICATE OF LIABILITY INSURANCE D10121 2014 rl 1o/zvzola 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 Flood and Peterson Corporate Mailing Address: P. 0. BOX 578 Greeley, CO 80632 ON C NAMEA Kylie Miller PHONE 970 266-7148 FAIL 970 506-6846 INC,No Eat : ac No ADDRESS: KMiller@FloodPeterson.com INSURER(S) AFFORDING COVERAGE NAIC 0 The Cincinnati Insurance Com an INSURER A : Compan Fiske, Inc. dba Fiske Electric 6766 E. County Road 18 Johnstown, CO 80534 INSURER B : Pinnacol Assurance INSURER C INSURER 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 CONTRACTOR 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. LTRR TYPE OF INSURANCE ADDLSUBR NSR MD POLICY NUMBER MWDDY EFF UP MMIDD/YYYYYY LIMITS A GENERAL LIABILITY EPP0168559 1/15/2014 11/15/2015 EACH OCCURRENCE $I000000 X COMMERCIAL GENERAL LIABILITY PREMISES EaE rrenw $500000 CLAIMSMADE FXI OCCUR MED EXP (Anyone person) E 1 O 000 PERSONAL B ADV INJURY $1000000 X PD Ded:1,000 GENERAL AGGREGATE E2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY X PR0. LOC E A AUTOMOBILE LIABILITY EBA0168559 1/15/2014 11115/201E COMBINED SINGLE LIMIT Ea ecddenl 1,000,000 INJURY(Per person) S ANYAUTOBODILY ALLOWNED SCHEDULEDAUTOSAUTOSBODILY IX INJURY (Per acdtlem) S PROPERTY DAMAGE Per accident SAUTOS HIREAUTOS X NON -OWNED E XDfWe Oth Car A X DMBRELLALIAB X OCCUR EPP0168559 1/15/201411/15/201 EACH OCCURRENCE E3000000 AGGREGATE s3,000,000 EXCESS LIAR CLAIMSMADE DED X RETENTION SO E B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? N (Mandatory In NH) N/A 4066524 3/01/2014 03/0112015 X I WCSTATU- OTH. E.L. EACH ACCIDENT S1 000 000 E.L. DISEASE - EA EMPLOYEE $1000000 If yes, descdbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT E1,000,OOO A Leased/Rented EPP0168559 11/15/2014 11/1512015 $50,000 Limit Equipment $1,000 Deductible DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (AKacb ACORD 101, Additional Remarks Schedule, It... apace Ia required) City of Fort Collins is named as Additional Insured with respects to General Liability if required by written contract. City of Fort Collins 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 ©1988.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S944682/M944638 KXM