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HomeMy WebLinkAbout507242 CUSTOM SOLAR LLC - INSURANCE CERTIFICATE (3)CUSTS-2 OP ID: TV ACORO" CERTIFICATE OF LIABILITY INSURANCE D 11/131201 YY) 11 N 3/2014 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 endorsements . PRODUCER CRS Insurance Brokerage Commercial Risk Solutions DBA CONTACT P ONE FAx uc No E,N :303-996-7801 A/C No : 303-757-7719 E—MAIL s: 6600 E. Hampden Ave. ' Denver, CO 80224 Jeffrey Berven INSURERS AFFORDING COVERAGE NAIC d INSURER A: Westfield Insurance 24112 INSURED Custom Solar LLC INSURERS: Plnnacol Assurance 2840 Wilderness Place, Ste F Boulder, CO 80301 INSURERc IxsRER D INSUuRER 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 ADOL UB POLICY NUMBER MMMIIOODY IYYYYI IMMIDDITTYYI LIMITS A X CONNIE ILGENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE X OCCUR X CWP0126513 11110/2014 11/10/2015 DAMAGE TO RENTED PREMISES(Ea occurrence $ 500,00 MED EXP (Any are parson) $ 5,00 PERSONAL S AOV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO- JECT LOC PRODUCTS-COMPIOPAGG$ 2,000,00 S OTHER: AUTOMOBILE LIABILITY COMBINEDSINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ A X ANY AUTO X CWP0126513 11/10/2014 11/10/2015 ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par accident) $ X X NON -OWNED HIREDAUTOS AUTOS PROPERTY DAMAGE Peramdent $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 A EXCESS LULB CLAIMS -MADE CWP0126513 11/10/2014 11/10/2015 OED X RETENTION$ 0 $ B WORXERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORMARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? M (Mandatory in NH) NIA - 4160305 12/01/2014 12/01/2016 XI PER OTH- STATUTE ER E. L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE -EA EMPLOYEE $ 1,000,00 N s. describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD tot, Additional Remarks SchWuls, may be aLtneahed If more space Is required) City of Fort Collins, its officers, agents and employees are included as additional insured for ongoing operations on the General Liability and included as additional insured on the Auto Liability with respect to operations of the named insured for the certificate holder as required by written contract. All policy terms, conditions and exclusions apply. CITYOFF City of Fort Collins Purchasing & Risk Management 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. AUTHORIZED REPRESENTATIVE 9V ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD