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HomeMy WebLinkAbout125947 PTACEK ENTERPRISES INC DBA BATTERIES PLUS - INSURANCE CERTIFICATE (3)ACOR" CERTIFICATE OF LIABILITY INSURANCE ��. DATE (M M/DD/YYYY) 7/23/2018 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 Molyneaux Insurance Inc. 5025 Utica Ridge Rd, Ste 100 Davenport IA 52807 NAME: CONTACT Kelly Webber PHONE 563-324-1011 FAIL No :563-324-7909 E-MAIL ADDREss: kelly.webber@molyneaux.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Travelers Property Casualty Ins Company 36161 INSURED PTACENT-01 INSURERB: The Standard Fire Insurance CO 19070 acek Enterprises, Inc. dba Batteries Plus Bulbs INSURER C : Travelers Property Casualty Co of America 25674 INSURERD: Travelers Indemnity Company 25658 I' 07'''J. Drake, Unit E-3 Fort Collins CO 80526 INSURERE: INSURER F : COVERAGES CERTIFICATE NUMBER: 1292980443 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. ILSR TYPE OF INSURANCE ADDLI WVD POLICY NUMBER MMI DPOLICY/YYYY EFF EXP MM/DDY/YYYY LIMITS C X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y 6802289W988 8/8/2018 8/8/2019 EACH OCCURRENCE $2,000,000 PREMDAMET RENTED PREMISES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PRO ❑ JECT LOC OTHER: GENERALAGGREGATE $4,000,000 PRODUCTS-COMP/OPAGG $4,000,000 $ A AUTOMOBILE IX X LIABILITY ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS X NON -OWNED HIRED AUTOS AUTOS BA615D3648 8/8/2018 8/82019 COMBINED SINGLE LIMIT $1000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccident $ D X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUP2061 W503 8/82018 8/8/2019 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1.000.000 DED I X I RETENTION $ 5 ono $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? 7 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A UB4J020914 8/82018 8/82019 X PER OTH- TATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000 000 i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Fort Collins Utilities 700 Wood St Fort Collins CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD