HomeMy WebLinkAboutPETERSON ELECTRIC LLC - INSURANCE CERTIFICATE (2)"
DATE (MM/DD/YYYY)
ACORDO CERTIFICATE OF LIABILITY INSURANCE
01/02/2019
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 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 C H A D TUCKER
NAMMOODY
INS AGENCY INC
8055 E TUFTS A V E S T E 1000
PHONE FAX
Ext) 888 793-1481 A/c No 800 9740297
E-MAILo.
ADDRESS: SERVICECENTER UNITEDFIREGROUP.COM
PRODUCER
DENVER CO 80237
CUSTOMER ID#
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
INSURER A: United Fire & Casualty COm
13021
B:
PETERSON ELECTRIC LLC
-INSURER
INSURER C:
INSURERD:
2355 CALCITE ST
INSURERE:
LOVELAND CO 80537-2004
INSURER F
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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.
INSR I
LTR
TYPE OF INSURANCE
DDL
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
COMMERCIAL GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE OCCUR
N
N
60350023
07/07/2018
07/07/2019
EACH OCCURRENCE
1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
100,000
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$ 1,000,00C
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO-
X POLICY JECT LOC
OTHER:
GENERAL AGGREGATE
$ 2 , 000, 00
PRODUCTS - COMP/OP AGG
$ 2 , OOO , OO
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
N
N
60350023
07/07/2018
07/07/2019
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY
Perperson)
$
BODILY INJURY
Per accident
$
X
PROPERTY DAMAGE
(Per accident)
$
$
$
UMBRELLA LAB
XCESS ELIAR
HCLAIMS-MADE
OCCUR
EACH OCCURRENCE
AGGREGATE
$
DEDUCTIBLE
RETENTION $
$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
PER
STATUATE
OTH-
ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, if more space is required)
CERTIFICATE HOLDER CANCELLATION
CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE
PO B O X 580 WITH THE POLICY PROVISIONS.
FORT COLLINS CO
8 0 5 2 2- 0 5 8 0 AUTHORIZED REPRESENTATIVE
Ar•non 99 nn4emit The Arnan 1,— i Innn - ranictarPlll mnrkc of ACnRD n 19RR_2n14 ACORD CORPORATION- All rights reserved-