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HomeMy WebLinkAboutTEPA EC LLC - INSURANCE CERTIFICATE (7)30305 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 2/27/2015 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 Commercial Lines - (800)-332-9256 Wells Fargo Insurance Services USA, Inc. 90 S. Cascade Ave. 2nd Floor Colorado Springs, CO 80903 INSURED TEPA EC, LLC 5045 List Drive Carissa Atenao 303-863-6396 WSURER(S) AFFORDING COVERAGE Old Republic Insurance Company Travelers Propertv Casualtv Co of America 877405-9032 Colorado Springs, CO 80919 I INSURER F: COVERAGES CERTIFICATE NUMBER: 8806150 REVISION NUMBER: See below 24147 25674 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. ILtR TYPE OF INSURANCE POLICY NUMBER MWDD EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I I OCCUR MWZY303868 3/1/2015 3/1/2016 EACH OCCURRENCE t 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence $ 500,OD0 MED EXP (Any one person) E 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2.000,000 POLICY a JJECTT LOC PRODUCTS - COMPIOP AGG t 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY MWTB303867 3/1/2015 3/1/2016COMBINED I a 1 S 1,000,000 BODILY INJURY (Per pamon) $ 5,000 ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS Ix BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accldeM $ xNON-OWNED HIRED AUTOS AUTOS $ B x uMBRELIAL1As x OCCUR ZUP-14T80862-15-NF 3/1/2015 3/1/2016 EACH OCCURRENCE f 5,000,000 AGGREGATE $ 5.000.000 EXCESS llAB CLAIMS -MADE DIED I x I RETENTION 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? FIN (Mandatory In NH) NIA MWC30386600 3/1/2015 3/1/2016 X PEA I OTM- TE ER E.L. EACH ACGDENT $ 1,000,000 E.L. DISEASE -EA EMPLOnd S 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1,000,000 = B Installation 660367M779ATI L 15 3/12015 3/1/2016 $250,000 Leased/Rented Equipment $250.000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, my be attached N more space Is required) Certificate holder is recognized as an additional insured as respects: Contractors License fax:970-224-6134 City of Ft. Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE P.O. Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins CO 805220580 AUTHORIZED REPRESENTATIVE The ACORD name and logo are registered marks of ACORD © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) IIIII I I IIIII I I II II II I I III III II III I IIII III III IIIII II II III III 'CYBWQV001203/02/02/010/0/0'