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HomeMy WebLinkAbout507424 CUSTOM SOLAR LLC - INSURANCE CERTIFICATE (2)® DATE (MM/DD/YYYY) �. CERTIFICATE OF LIABILITY INSURANCE F11/9/2018 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 Commercial Risk Solutions NAME: __Caytlyn„Green 6600 E Hampden Ave Ste 200 PHOC.NE - 303-996-7840 Fax . 303-757-7719 Denver CO 80224 ADDRESS: cgreenQcrsdenver.com INSURE US AFFORDING COVERAGE �_ NAICA INSURERA: Westfield Insurance 24112 INSURED CUSTS-2 INSURER B : Pinnacol Assurance 41190 Custom Solar LLC 2840 Wilderness Place, Ste F INSURER C : Boulder CO 80301 INSURER D: INSURER E : COVERAGES CERTIFICATF NIIMRFR:1457A9n733 RFVISION NIIMRFR- 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. ILTR TYPEOFINSURANCE AN SU R POLICY D/YYY PMtDD/Y YY) I LIMITS LTR ' I POLICY NUMBER MM.'DD�YYYY MM1DD/YYY I A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Y CWP0126513 11/10/2018 11/10/2019 EACH OCCURRENCE $ 1,000,D00 _ _SEP � .Mt3.F�.LE�.s.�GUS[tln.�.el)_ $ 500,000 PERSONAL 8 ADV INJURY $ 1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- �--I POLICY r_X l; PRO' LOC _ OTHER: GENERAL AGGREGATE $ 2,000,000 ------ PRODUCTS - COMP/OP AGG --------- $ 2.000,000 _—_ $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED x NON -OWNED AUTOS ONLY AUTOS ONLY Y CWP0128513 11l10l2018 I 11/10/2019 COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTVDAMAGE (Per accidttnL $1,000,000 $ $ $ $ A X UMBRELLA LAB EXCESS LIAB �X OCCUR CLAIMS -MADE CVVP0126513 11/1012018 ! 11/10/2019 EACH OCCURRENCE Y AGGREGATE $1,000,DD0 $1,000,000 DED ! X RETENTION $ n $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICERWEMBEREXCLUDE D? (Mandatory In NH) Pies, describe under DESCRIPTION OF OPERATIONS below NIA I 4160305 12/1/2018 12/1/2019 X PTA __ ERH - I E.L. _EACH ACCIDENT_ I — E.L. DISEASE - EA EMPLOYEE! __-_. _ E.L. DISEASE POLICY LIMIT -- $ 1,000,000 -- $ 1,000,000 _ $ 1,000,000 I i I I DESCRIPTION OF OPERATIONS! LOCATIONS) VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 11 more space is required) Certificate Holder is included as additional insured for ongoing operations on the General Liability and included as additional insured on the Auto Liability with respect to operations of the named insured for the certificate holder as required by written contract. All policy terms, conditions and exclusions apply. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Department PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2 of 2 1441 1