HomeMy WebLinkAboutREGENCY ELECTRIC INC - INSURANCE CERTIFICATEACORO®
16-� CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
08/23/2018
I
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 have ADDITIONAL INSURED provisions or 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
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328
CONTACT
NAME: CLIENT CONTACT CENTER
A CNNo Ext : 888-333-4949 FAX
No): 507-446-4664
E-MAIL
ADDRESS: CLIENTCONTACTCENTER FEDINS.COM
OWATONNA, MN 55060
INSURER(S) AFFORDING COVERAGE
NAIC k
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 258-836-6
INSURER B:
REGENCY ELECTRIC INC
INSURER C:
4725 S SANTA FE CIR
INSURER D:
ENGLEWOOD, CO 80110-6471
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 40 REVISION NUMBER: 0
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
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMIDDIYYYV
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
N
N
9290882
10/01/2018
10/01/2019
EACH OCCURRENCE
$1,000,000
PrMIS ES AGE ToEa o. cRENTc
rDence
$100,000
MED EXP (Any one person)
EXCLUDED
GEN'L
�OTHER:
PERSONAL & ADV INJURY
$1,000,000
AGGREGATE LIMIT APPLIES PER:
POLICY ❑ JECT LOC
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP/OP AGG
$2,000,000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
OWNED AUTOS ONLY SCHEDULED
AUTOS
HIRED AUTOS ONLY NON -OWNED
AUTOS ONLY
N
N
9290882
10/01/2018
10/01/2019
COMBINED SINGLE LIMIT
Ea accident
$1,000,000
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
Per accident
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
N
N
9290883
10/01/2018
10/01/2019
EACH OCCURRENCE
$5,000,000
AGGREGATE
$5,000,000
DED I RETENTION
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXEC UTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
N
9820444
10/01/2018
10/01/2019
X
PER STATUTE
OTH-
ER
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA EMPLOYEE
$1,000,000
E.L DISEASE -POLICY LIMIT
$1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
258-836-6
40 0
CITY OF FORT COLLINS
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES
BE CANCELLED BEFORE
PO BOX 580
THE EXPIRATION DATE THEREOF, NOTICE
WILL BE DELIVERED IN
FORT COLLINS, CO 80522-0580
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
/1
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