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HomeMy WebLinkAboutCHADWICK ELECTRIC INC - INSURANCE CERTIFICATE (5)CHADELE-01 LWEISBRO FACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/23/2019 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 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 PFS Insurance Group 4848 Thompson Parkway Suite 200 Johnstown, CO 80534 INSURED Chadwick Electric, Inc. 1281 E Magnolia Unit D #134 Fort Collins, CO 80524 COVERAGES CFRTIFICATF NHMRFR- : (970) 635-9400 1 (A%C, Ni ifo@mypfsinsurance.com INSURER(S) AFFORDING COVERAGE Employers Mutual Casualty Company Pinnacol Assurance Co EMC Insurance Group REVISION NUMBER: 635-9401 1415 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTRA X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE Fv� OCCUR 5D21544 11/14/2018 11/14/2019 DAMAGE TO RENTED P MI E Ea ccurrence 300,000 $ MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY � jEe7 LOC OTHER: A AUTOMOBILE LIABILITY CO aBcl .r") SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ X ANY AUTO 5E21544 11/14/2018 11/14/2019 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS ParOaccitlentDAMAGE $ X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 EXCESS LIAB CLAIMS -MADE 5J21544 11/14/2018 11/14/2019 AGGREGATE $ 2,000,000 DIED I X I RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PXCLUDElEXECUTIVE Yl�j (FFICER/MEMBER EXCLUDED? u (Mandatory in NH) N /A 4051845 6/1/2019 6/1/2020 X PER OTH- STATUTE E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE _ $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below C Leased Equipment 5C21544 11/14/2018 11/14/2019 $500 Deductible 25,000 C Installation Floater 5C21544 11/14/2018 11/14/2019 $500 Deductible 900,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: License Renewal. If required by written contract the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder is named as Additional Insured for ongoing operations on a Primary and Non -Contributory basis under General Liability and Automobile Liability. If required by written contract, a Waiver of Subrogation in favor of the Certificate Holder applies to the General Liability, Automobile Liability and Workers' Compensation. Umbrella provides excess coverage over the General Liability, Automobile Liability and Workers' Compensation. City of Fort Collins PO Box 580 Fort Collins, CO 80522 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 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD