HomeMy WebLinkAboutT'S ELECTRIC LTD - INSURANCE CERTIFICATE (4)A` ORO® CERTIFICATE OF LIABILITY INSURANCE
DATE Y 5
03/12/2015
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
Ronny Bush State Farm Insurance
StateFarm 1090 E Elizabeth St
{
• Fort Collins, CO 80524
`•7W
CONTACTRONNY BUSH
NAME:
PNDNE 970 484-3993 FAX Ne:s7o 48a 4011
E-MAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC#
INSURER A :State Farm Fire and Casualty Company
25143
INSURED TES ELECTRIC LTD
1420 BLUE SPRUCE DR STE I
FORT COLLINS CO 80524-5426
INSURERS:
INSURERC:
INSURERD:
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
MM/DOY EFF
POLICY EXP
MIDD/YYYY
LIMITS -
X
COMMERCIAL GENERAL LIABILITY '
CLAIMS -MADE OCCUR
-
- - - 96-B2-PO64-7
..
.
03/28/2015
03/28/2016
EACH OCCURRENCE ..
$ 1,000.000
A
PREMISE a occurrence)
$
.MED-EXP (Any one.personj...
$ 5,000
PERSONAL B ADV INJURY
$.
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JECOT- LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS-COMP/OP AGG
$ _
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
COMBINE rSINGL rLIMI
Ea accident
$
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)$
$
PROPERTY DAMAGE
Per accdent
_
UMBRELLA LIAB OCCUR
EXCESS LIAB CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTIONS
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY ,r i N
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yes, desvibe under
DESCRIPTION OF OPERATIONS below
NIA
PERT TH-
STUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
- - --
$
E.L. DISEASE -POLICY LIMIT
$
DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more Space Is required)
CITY OF FORT COLLINS
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
(c)1985--2014 ACORD CORPORATION. All riahts reserved
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014