HomeMy WebLinkAboutMEYER AND SONS ELECTRIC CO - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
12/27/2018
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).
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PRODUCER
CONTACT
NAME: Jeffrey M. Helms
Farmers Insurance
PHONE
FAX
Helms Insurance Services, LLC.
(A/c NO, EXT): 970-353 8900
-
(A/C. NO) 970-353-1014 ...........
929 38th Avenue Ct Ste 101
E-MAIL
Greeley CO 80634-1546
ADDRESS: jhelms@farmersagent.com
.............. .....- _-...--_.._............_........----__..._.. - - —..
INSURER(S) AFFORDING COVERAGE
—-_...---- _.._.__.— _.... --
NAIC N
- _............
.......� — _.._....
INSURED
- -
-- --........... - ___ ------
INSURER A: Truck Insurance Exchange
21709
INSURERB: Farmers Insurance Exchange
21652
MEYER AND SONS ELECTRIC CO
" ' .......---------- -------- '
INSURER.: Mid Century Insurance Company
21687
5951 W 26TH ST
_ -- -- -
INSURER D:
I INSURERS:
GREELEY CO 80634
i INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
rTHIS IS TO CERTI FY THAT TH E POLICIES OF INSURANCE LISTED BELOW HAVE BE EN ISSUED TO THE INSURED NAME 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 SUCK POLICIES. LIMITS SliOWN MAY HAVE BEEN REDUCED
BY PAID CLAIMS.
INSR TYpEOFiNSURANCE
ADDTL
SUBR POLICY NUMBER
POLICY EFF POLICY EXP
LIMITS
LTR
INSD
WVD
(MM/DD/YYYY) (MM/DD/YYYY)
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1000000
X
— ......._..
DAMAGETO RENTED
. - -
$
CLAIMS -MADE ;OCCUR
PREMISES (Ea Occurrence)
100,000
MED EXP (Any one person)
-. ._.
$ 5,000
- -
A
- -- - --
N
N 602994865
12/13/2018 12/13/2019
PERSONAL & ADV INJURY
---. . . - - —
$ 1,000,000
--........._.
GEN'L
AGGREGATE LIMrrAPPLIES PER:
GENERAL AGGREGATE
$ 2,000000
POLICY PROJECT n LOC
PRODUCTS-COMP/OPAGG
$ 2,000,000
OTHER:;
----------
-
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$ 1,000,000
(Ea accident)
BODILYINJURY(Perperson)
$
ANY AUTO
A
OWNEDAUTOS SCHEDULED
X,AUTOS
BODILY INJURY (Per accident)
$
ONLY
602994865
12/13/2018 12/13/2019
�~
PROPERTY DAMAGE
$
HIREDAUTQS NON -OWNED
ONLY AUTOS ONLY
(Per accident)
$
UMBRELLALIAB OCCUR
D
EXCESS LIAB CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
I
._. _.AI - - --
DED RETENTION $
$ - ._ ___._ .........
WORKERS COMPENSATION j
PER OTHER
$
AND EMPLOYERS'LIABILITY
i
STATUTE
ANY PROPRIETOR/PARTNER/ YIN
E.L. EACH ACCIDENT
$
j EXECUTIVEOFFICE R/MEMBER .._._.__._ N/A
..............:------ ............._............ ............. _... _._...__...:....__....._..__.-------
EXCLUDED? (Mandatory in NH) j
E.L. DISEASE - FAF.MPLOYEF
Ifyes, describe under DESCRIPTION OF
, OPERATIONS below
E.L.ISI-ASE- POLICYIIMIT
$
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i
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DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
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1940 E COLLINS ST, EATON, CO 80615
CERTIFICATE HOLDER
City of Fort Collins
PO Box 580
Fort Collins
ACORD 25 (2016/03)
31-1769 1 1-15
CANCELLATION
SHOULDANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION
DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
CO 80522-0580 C%?Z�
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