HomeMy WebLinkAboutCHADWICK ELECTRIC INC - INSURANCE CERTIFICATE (3)OP ID: RC
AFRO" CERTIFICATE OF LIABILITY INSURANCE
11/13/2014
D11/132014
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
PFS Insurance Group - JT
4848 Thompson Pkwy, Ste 200
CONTACT
'PHONE FAX
AIC N_0Exr: (A/C, ,No:
Johnstown, CO 80534
Dave Janssen
E'MAIL
ADDRESS,
PRODUCER CHADW-1
CUSTOMER ID p:
INSURERS AFFORDING COVERAGE
NAIC 0
INSURED Chadwick Electric, Inc. &
INSURER A: EMC Insurance Companies
21415
Chadwick Electric Services,
INSURER B: Pinnacol Assurance
41190
Inc.
1281 E. Magnolia Unit D #134
INSURER C:
Fort Collins, CO 80524
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 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
rypE OFINSURANCE
POLICY NUMBER
POLICYEFF
MMIO
POL1CYEXP
MMIDDIYYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
X BlanketAdd'llns
SD21544
11/14/2014
11/14/2015
EACH OCCURRENCE
$ 1,000,00
PREMISES Ea occurrence
$ 300,00
MED EXP (Any one person)
$ 5,00
PERSONAL & ADV INJURY
$ 1,000,00
X
Blanket Waiver
GENERALAGGREGATE
$ 2,000,00
GEN'L AGGREGATE
17 POLICY
LIMIT APPLIES PER
X PRO-
IFQ.T 1-1 LOC
PRODUCTS - COMP/OP AGG
$ 2,000,00
$
A
p
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNEDAUTOS
Blanket Add'I Ins
SE21644
11/14/2014
11/14/2015
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,00
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(PER ACCIDENT)
$
X
X
$
X
$
A
X
UMBRELLALUIB
EXCESS LIAB
X
OCCUR
CLM AIMS-ADE
5J21544
11/14/2014
1 iN4/2015
EACH OCCURRENCE
$ 1,000,00
AGGREGATE
$ 1,000,00
DEDUCTIBLE
RETENTION $
$
$
B
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORRARTNER/EXECUTIVE YIN
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
Ifr dese under
DESCRcribIPTION OF OPERATIONS be.
NIA
4051845-CHADWICK ELECTRIC
4144024-CHADWICK SERVICES
06/01/2014
06/01/2014
06/01/2015
06/01/2015
X WC STATU- X OTH-
TOBYLU
E.L. EACH ACCIDENT
$ 1,000,00
E.L. DISEASE - EA EMPLOYEE
$ 1,000,00
E.L. DISEASE - POLICY LIMIT
$ 1,000,00
p
A
Equipment
Installation
5C21544
SC21644
11/14/2014
111141201411111412015
11/14/2015
Leased 5,00
Limit 100,00
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ANaeb ACORD 101, Additional RemarW S lteduls, if mors space Is rsqulred)
Re: License Renewal
FTCOLLI
City of Ft. Collins
P.O. Box 580
Ft. 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
AlizeA
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