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HomeMy WebLinkAbout563480 SGL ENERGY SYSTEMS INC - INSURANCE CERTIFICATE,4coRD0 CERTIFICATE OF PROPERTY INSURANCE I DATE (MM/DD/YYYY) 02/04/2019 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. PRODUCER CONTACT NAME Aon Risk Services, Inc. of Washington, D.C. PHONE FAX 1120 20th Street NW (A/C. No. Ext>: (866) 283-7122 (A/C. No.): 800-363-0105 Washington DC 20036 USA pMRIFCC CUSTOMER ID>t: lOS68397 INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: AXIS Specialty Europe SE AA178413 WGL Energy Systems, Inc INSURER B: a subsidiary of Washington Gas INSURER C: Resources INSURER D: 8614 Westwood Center Drive, INSURERE: suite 1200 Vienna VA 22182 USA NSURER F: !`(N/CDA/]CC !`CDTICIr ATC All NIIIDCD• S7nn7SMlnnn DC\/ICV1KI A1111111DCD. LOCATION OF PREMISES/ DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Solar Photovoltaic System, Fort Collins Job Site: 1912 LaPorte Ave, Fort Collins, CO 80521. 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) COVERED PROPERTY LIMITS A X PROPERTY CAUSES OF LOSS DEDUCTIBLES 3776650119ES IEXTRA 01/31/2019 10/01/2019 BUILDING PERSONAL PROPERTY BUSINESS INCOME EXPENSE RENTAL VALUE BLANKET BUILDING BLANKET PERS PROP BLANKET BLDG & PP Newly Acquired Property Flood - Per Loc/Occ BASIC BUILDING BROAD X SPECIAL CONTENTS X EARTHQUAKE WIND X FLOOD X $15,000,000 X $10,000,000 INLAND MARINE OF LOSS NAMED PERILS TYPE OF POLICY CAUSES POLICY NUMBER CRIME TYPE OF POLICY BOILER & MACHINERY / EQUIPMENT BREAKDOWN SPECIAL CONDITIONS / OTHER COVERAGES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins CERTIFICATE HOLDER CANCELLATION City of Fort Collins Utilities Department Attn: Norm Weaver 970-221-6700 PO Box 580 Fort Collins Co 80522-0580 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE �'/ J^lcn if 7L��i cfatz�ri�« �J�u. s� l,�ruasaa���& © 1995-2015 ACORD CORPORATION. All rights reserved. ACORD 24 (2016/03) The ACORD name and logo are registered marks of ACORD c� 67 'O .b 0 x 0 0 0 r•H 0 0 n CD O n It W m Z W Q U LL_ F- CC W U AGENCY CUSTOMER ID: 10568397 LOC #: ADDITIONAL REMARKS SCHEDULE Page _ of _ AGENCY NAMED INSURED Aon Risk Services, Inc. of Washington, D.C. WGL Energy Systems, Inc POLICY NUMBER see Certificate Number: 570075001000 CARRIER NAIC CODE EFFECTIVE DATE: See certificate Number: 570075001000 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 24 FORM TITLE: Certificate of Property Insurance INSURER(S) AFFORDING COVERAGE I NAIC # INSURER INSURER INSURER INSURER If a policy below does not include limit information, refer to the corresponding policy on the ACORD ADDITIONAL POLICIES certificate form for policy limits. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYYY) POLICY EXPIRATION DATE (MM/DDIYYYY) COVERED PROPERTY LIMITS PROPERTY A 3776650119ES 01/31/2019 10/01/2019 Flood - Agg $25,000,000 Earth Per LOC/OCC $10,000,000 Earthquake - Agg $25,000,000 indstorm Agg $25,000,000 ind Per LOC/OCC $10,000,000 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD