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Home My WebLink AboutR. HOFFMAN'S ELECTRIC INC - INSURANCE CERTIFICATEACC) CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 9/24/2018 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 endorsements . PRODUCER CONTANAME, Dustin Sadowski Ewing -Leavitt Insurance A Inc. PHONE F (866)456-4265 Agency, y' WC Nc Ex 4090 Clydesdale Parkway E-MAILSS:dustin-sadowski@leavitt.com Suite 101 INSURERS AFFORDING COVERAGE NAIC 0 Loveland CO 80538 INSURERA:Owners Insurance Comapany 32700 INSURED INSURER B :Pinnacol Assurance 41190 R. Hoffman's Electric, Inc. INSURERC: 4904 Glade Rd. INSURE RD: Loveland CO 80538 I INSURER F COVFRAGFS r9:0TIPlrATC A11111ADCD.1 A-1 O M--+-e- - �wwn rw rno�rt. 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 ADDL SUBR LTR TYPE OF INSURANCE INAn POLICY NUMBER LIMITS POLICY EFF POLICY EXP A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea 300,000 occurrence)$ MEDEXP (Any one person) $ 10,000 74002232 9/27/2018 9/27/2019 PERSONAL 8 ADV INJURY $ 1,000,000 GEN'L X AGGREGATE LIMIT APPLIES PER: PRO- POLICY PRO ❑ LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 OTHERIs AUTOMOBILE LIABILITY EO aBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS 4601718400 9 27/2018 / 9/27/2019 BODILY INJURY Per accident ( ) $ HIRED AUTOS X NON -OWNED AUTOS X PROPERTY DAMAGE Per accident $ X UMBRELLA LIAR ��x OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAR CLAIMS MADE DIED RETENTION $ 4601718401 9/27/2018 9/27/2019 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) if yes, describe under DESCRIPTION OF OPERATIONS below NIA 4126151 10/1/2018 10/1/2019 I PER OTH- X STATUTE I ER E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYE $ 1 000 000 �— L_.. _. $ 1 000,000 — E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H more space is required) (970)224-6134 City of Fort Collins 281 N. College Ave Fort Collins, CO 80524 CLLN 11V1Y 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 D Sadowski/DUSADO U 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD