HomeMy WebLinkAboutCHADWICK ELECTRIC INC - INSURANCE CERTIFICATE (4)CHADELE•01 VMAT.H..I..A.$.
ACORU' CERTIFICATE OF LIABILITY INSURANCE DATE (MMJDINYYYY)11/26/2018
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
PIPS Insurance Group
4948 Thompson Parkway Suite 200
Johnstown, CO $0534
INSURED
Chadwick Electric, Inc.
1281 E Magnolia Unit D #134
Fort Collins, CO 80524
a rco,N o, Ext 970 635-9400
F:
EMC
THIS IS TO CERTIFY 'THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSU
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHEI
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
TYPE OF INSURANCE POLICY NUMBER Ittl.�liD��XYYYi. SM11ti9.R1Y,XYY1
COMMERCIAL GENERAL LIABILITY
_....� CLAIMS -MADE t ^J OCCUR 5D2i544 11114/2018 11114/2019
L AGGREGATE LIMIT APPLIES PER:
POLICY I -- I jpeT ED LOC
A I AUTOMOBILE LIABILITY
X ANY AUTO 5E21544 1111414018 11114/2019
AUUTEO�S ONLYHAUTOSOpUL.FEED
X AUTOS ONLY AUOTUSUNLDY
A
X UMBRELLA LIAB X OCCUR
EXCESS LIAB CLAIMS -MADE
SJ21544
11/1412018
11H4/2019
....
DED X RETENTION $ 10,000
............
.._......
..... ..................... _ _.__. __......_.. ._....._....__....
B
_.._........_._._...............................................
WORKERS...COMPENSATION
AND EMPLOYERS' LIABILITY
Y'
4051845
6I112018
6(112019
ANY PPOPRIETORIPARTNF.RIEXECI ITIVE
OFFICER/MEMBER EXCLUDED? .__
( in NH)
Mandatory
111 A
it yes, describe under
DESCrdIP,nibe OF OPEI2ATIONS,below
C
Leased Equipment
5C21544
11/1412018
11/14/2019
C
Installation Floater
5C21544
11114)2018
11/14/2019
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is requ
Re: License Renewal. If required by written contract the following provisions apply subject to the policy terms,
Certificate Holder is named as Additional Insured for ongoing operations on a Primary and Non -Contributory ba
Liability. If required by written contract, a Waiver of Subrogation in favor of the Certificate Holder applies to the
Workers' Compensation. Umbrella provides excess coverage over the General Liability, Automobile Liability an
635-9401
QFtlACInId NI1tU1RF0•
_ _ _._..._..__._._..__. ._....__.._......._...._._............. .......
ZED NAMED ABOVE FOR THE POLICY PERIOD
t DOCUMENT WITH RESPECT TO WHICH THIS
ED HEREIN IS SUBJECT TO ALL THE TERMS,
ry » ~» LIMITS
....... ,_.... ....... ........ _..... ...
NC
EACH OCCURREE $
11000,000
GE TO RENTED
DAMAGE
300,000
MED EXP An one pegRn
g
10,000
PERSONAL 8 ADV INJURY
S
__......_......_......._.._
1.000,000
...........__
__.._..__._.._._..._._
GENERAL AGGREGATE
S
2.001,000
_
PRODUCTS - COMPIOP AGG
S
2,000,000
EMPLOYEE BENEFI
$
2,000,000
COMBfNED SINGLE LIMIT
_(Ea.24 i pm) ............... I ...................
$
....
1,000,000
BODILY INJURY Per „rson
S
BODILY INJURY (Per aocidydl
S
PROPERTY DAMAGE
Per accident
2,000,000
AGGREGATE
$
2,000,000
....._............
_............__...._ »S
X..._mU1TE.L Eft».....
».._.._...._....._.....
_....._.
E.L. EACH ACCIDENT,. S
... _...... ....._..._......._.....
1,000,000
E.L. DISEASE - EA EMPLOYEE S
1,000,000
E.L. DISEASE -POLICY LIMIT s
1,000,000
$500 Deductible
25,000
$500 Deductible
900,000
red)
:onditions, limitations and exclusions: The
;is under General Liability and
Automobile
3eneral Liability, Automobile Liability and
d Workers' Compensation.
------------------
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Y ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
Fort Collins, CO 80522........................................... ..................................................... .............. _... ................. ._............. ._................ _..............
.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD