HomeMy WebLinkAboutWESTECH MECHANICAL INC - INSURANCE CERTIFICATEAC-QR" CERTIFICATE OF LIABILITY INSURANCE DATE(MNLDD'YYYY)
`.. 1 8/30/2018
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 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 endorsement(s).
PRODUCER CONTACT
NAME__ Sabrina Rahe
Commercial Risk Solutions PHONE FAX
6600 E Hampden Ave Ste 200 a? No t • 303-996-7834 Arc No): 303-996-7851
Denver CO 80224 ao AIL srahe(cD-crsdenver.com
INSURERS) AFFORDING COVERAGE
10804
INSURED '-''E`1E-j
INSURERS: PlnnaCOl Assurance 41190
Westech Mechanical, Inc. --- -
4755 Fox Street INSURERC:
Denver CO 80216-1824 INSURER D :
INSURERE:
INSURER F :
COVFRAGFS CFRTIFICATF NI IRARFR- 1 )r QQ9AQ7 R1zVICIr1N NI IMRGR•
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVF 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.
S TYPE OF INSURANCE L POLICY EFF POLICY EXPP
ILTIR POLICY NUMBER /YYY MM/DD/YYYY LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE 1_X J OCCUR
CPA3045070
10/16/2017
10,''16/2018
EACH OCCURRENCE $1,000.000
DAMAGE TO RENTED
PREMISES_tEa %Eurrenoel i $ 300.000__-
MED EXP (Arry one n
$10,000
—
PERSONAL & ADV INJURY
$1,000,000
AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO -
POLICY LOC
GENERAL AGGREGATE
$ 2.000.000
GENL
PRODUCTS - COMPJOP AGG
$ 2,000,000
$
OTHER!
A
AUTOMOBILE LIABILITY
.'.
CPA3045070 10116/2017
10/1612018
COtdBINED SINGLE LIMIT
E. aocidentJ„
$1,000,000
BODILY INJURY (Per Person)
$
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY !AUTOS
8001LY INJURY (Per axkterlt)
$
X HIRED X ', NON -OWNED
AUTOS ONLY �� AUTOS ONLY
—
PROPERTY DAMAGE
P t
------
$
_
$
'X
A
X
UMBRELLA LIAR
OCCUR
CPA3045070
10118/2017
1011&2018
EACH OCCURRENCE
$5,000.000
EXCESS LIAR
CLAIMS MADE
AGGREGATE
DEC) i X RETENTION
$
?
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
�
ANYPROPRIETOR'PARTNER/EXECUTIVE
OFFICERWEMBEREXCLUDED? a
MIA
4128073
811/2018
9/112019
X P R OTH-
STATUT ER
$1000,000
E.LEACH ACCIDENT
— —
E.L. DISEASE - EA EMPLOYEE
-----
$1,000,000
(Mandatory In NH)
If yes. describe under
DESC RIPTIUN OPERATIONS below
E.L.DISEASE - POLICY LIMIT
_
$1.000.000
A
I
LeasedRented Equip
Special Form/ACV
CPA3045070 10/16/2011 I 10116/2018 Limit 25,000
Deductible 500
DESCRIPTION OF OPERATIONS r LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule. may be attached if more space is required)
All policy terms, conditions and exclusions apply.
Ut_F1I Ir-IGAIt r1VLUtr1 GANGtLLAI ION
City of Fort Collins Community Planning Environment
P.O. 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 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD