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HomeMy WebLinkAbout409545 ENCORE ELECTRIC INC - INSURANCE CERTIFICATEP5260(128002 DATE(MMIDDIYYYY) AC ORU CERTIFICATE OF LIABILITY INSURANCE I 12/26/2018 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 1-800-247-7756 CONTACT NAME: Holmes Murphy & Assoc - WDM PHONE FAX (AI4..No.Extim -(A/C, No : -- E-MAIL PO Box 9207 ADDRESS: INSURERS AFFORDING COVERAGE NAIC / Des Moines, IA 50306-9207 INSURER A:ZURICH AMER INS CO 16535 INSURED INSURERS: TRAVELERS CAS INS CO OF AMER 19046 Encore Electric, Inc. INSURER C : 7125 W. Jefferson Avenue, Suite 400 INSURER D: INSURER E : Lakewood, CO 80235 INSURER F: COVERAGES CFRTIFICATF NIIMRER. 54929543 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. NOTWITHS"IANDING ANY REQUiREMEN7, 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 I TYPE OF INSURANCE ADDL INSO SUER WVDI POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MWODIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLO1125116-00 01/01/19 05/01/19 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES JEa occurrence - -- - $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY � JECT lxl LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: A AUTOMOBILE LIABILITY _ BAP1125117-00 01/01/19 05/01/19 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED _ AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE Per accident $ X HIRED NON -OWNED AUTOS ONLY AUTOS ONLY rx B UMBRELLA LIAB X OCCUR ZUP-16N39815-19-NF 01/01/19 01/01/20 EACH OCCURRENCE $ 15,000,000 AGGREGATE $ 15, 000, 000 EXCESS UAB CLAIMS -MADE DED I I RETENTION $ 0 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOPJPARTNERIEXECUTIVE WC112115-00 01/01/19 05/01/19 X STATUTE ERH E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUI ❑ (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mom apace is required) RE: RFP 8667 Arch Flash Analysis. City of Fort Collins is an additional insured on general liability and automobile liability if required by written contract. If the liability policies are cancelled by the issuing companies, 30 days notice will be provided to the certificate holder. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ty of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins„ CO 80522 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD chellmanwdsm 54929543 0 00 z W M POLICY NUMBER: COMMERCIAL AUTO CA 04 44 10 13 w 0 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ^' WAIVER OF TRANSFER OF RIGHTS OF RECOVERY 00 AGAINST OTHERS TO US (WAIVER OF SUBROGATION) > W This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Endorsement Effective Date: SCHEDULE Name(s) Of Person(s) Or Organization(s): AS AGREED PER WRITTEN CONTRACT OR WRITTEN AGREEMENT. Information required to complete this Schedule if not shown above will be shown in the Declarations. The Transfer Of Rights Of Reoovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1