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HomeMy WebLinkAboutBENCHMARK ELECTRICAL SOLUTIONS INC - INSURANCE CERTIFICATE (3)A� " CERTIFICATE OF LIABILITY INSURANCE DATE (MWDD/YYYY) 9/10/2018 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 CONTANAME: CT Kylie Carey, CISR, CIC (AIC N (970) 266-7148 F� No: (970)506-6845 Flood and Peterson PO Box 578 E-MAIL ADDRESS: p y KCare @flood eterson.com INSURERS AFFORDING COVERAGE NAIC k INSURERA:Kinsale Insurance Company 38920 Greeley CO 80632 INSURED INSURERB:Acadia Insurance Company 31325 INSURERC:Travelers Excess and Surplus Lines 29696 Benchmark Electrical Solutions, Inc. INSURER D:TravelersProert Casualt Co.OfAmer. 25674 3665 Canal Drive, Unit A INSURERE:Pinnacol Assurance 41190 INSURER F:Zurich American Insurance Company Fort Collins CO 80524 16535 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 ADDL SUER POLICY NUMBER MOLIDY YYY MM DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISESEaoccurence $ 100,000 MED EXP (Any one person) $ Excluded 01000392992 6/1/2018 6/1/2019 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY a JJECT LOC PRODUCTS - COMP/OPAGG $ 2,000,000 Pollution Liability $ $lM/$2M OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS CPA3063807 6/1/2018 6/1/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED X HIRED AUTOS X AUTOS Medical payments $ 5,000 X UMBRELLA LIAS X OCCUR 01000393042 6/1/2018 6/1/2019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAR CLAIMS -MADE DED I X I RETENTION$ 10,000 $ E F WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YEN OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) NSA 4212299 - Colorado Only WC1127464-00 Other States Coverage; 9/16/201 8 9/16/2018 6/1/2019 6/1/2019 X PER STATUTE ERH E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE- EA EMPLOYEE $ 1,000,000 It as, describe under DESCRIPTION OF OPERATIONS below NM, OK, PA, TX, WV E.L. DISEASE - POLICY LIMIT $ 1,000,000 C Excess Liability ZUPB1M5951918NF 6/1/2018 6/l/2019 $5,000,000/$5,000,000 D Leased/Rented Equipment 6J7766737 6/1/2018 6/1/2019 $250,000Limd $2,500 Ded- DESCRIPTION OF OPERATIONS / LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins, CO THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. BOX 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0000 AUTHORIZED REPRESENTATIVE K Carey, CISR, CIC/KC ACORD 25 (2014/01) The ACORD name and are © 1988-2014 ACORD CORPORATION. All rights reserved.