HomeMy WebLinkAbout409545 ENCORE ELECTRIC INC - INSURANCE CERTIFICATE (2)P5260028(K)2
,d►CORiY' CERTIFICATE OF LIABILITY INSURANCE
DATE
04/2 /201YYY)
4/252019
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
Holmes Murphy 6 Assoc - WDM
CONTACT
NAME:
_
PHONE FAX
(A/�N1-_
E-MAIL
ADDRESS:
PO Box 9207
INSURERS AFFORDING COVERAGE
NAIC #
_ _
INSURERA:ZURICH AMER INS CO
16535
Des Moines, IA 50306-9207
INSURED
Encore Electric, Inc.
INSURERB: TRAVELERS CAS INS CO OF AMER
19046
INSURER C
INSURERD:
7125 W. Jefferson Avenue, Suite 400
INSURER E :
INSURERF:
Lakewood, CO 80235
COVERAGES CFRTIFICATF NIIMRFR• 56036165 RFVIRIr1N 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. 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
ADDL
SUER
POLICYNUMBER
POLICY EFF
MM/DD
POLICY EXP
MMIDD
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
GLO1125116
05/01/19
05/01/20
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE X OCCUR
DAMAG T R
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 10,000
PERSONAL BADV INJURY
$ 1,000,000
GENI AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY a PRO- ['� LOC
JECT
PRODUCTS-COMP/OPAGG
$ 2,000,000
$
OTHER:
A
AUTOMOBILE
LIABILITY
BAP1125117
05/01/19
65/01/20
COMBINED SINGLE LIMIT
Ee accident
$ 1,000,000
_
BODILY INJURY (Per person)
$
X
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident)
E
X
HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTYDAMAGE
Per accident)
$
$
B
X
UMBRELLA LIAB
X
OCCUR
ZUP-16N39815-19-NF
01/01/19
01/01/20
EACH OCCURRENCE
$ 15,000,000
AGGREGATE
$ 15, 000, 000
EXCESS LIAR
CLAIMS -MADE
DED RETENTION $ 0
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNERIEXECUTIVE
OFFICER/MEMBEREXCLUDED?
NIA
WC112115
05/01/19
�05/01/20
PER
X1 STATUTE I I ERH
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
i
DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more 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.
GtKIIYIGAIt MULUtK UANGtLLAIIUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City 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 80522R1
USA
C 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
chellmanwdsm
56036165
0000
r�
0
z
W
P5260028002
0
Additional Insured — Automatic — Owners, Lessees Or Z U RI C H
Contractors
Policy No. Eff. Date of Pol. Exp. Date of Pol. Eff. Date of End. Producer No. AddT Prem Return Prem.
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured:
Address (including ZIP Code):
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization whom you
are required to add as an additional insured on this policy under a written contract or written agreement executed by
you but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" if:
1. The written contract or written agreement specifically requires that you provide that the person or organization be
named as an additional insured under the Insurance Services Office (ISO) ISO CG20 10 10/01 edition or the ISO
CG20 37 10/01 edition, then such party is an additional insured only to the extent that "bodily injury" "property
damage" or "personal and advertising injury" arises out of your ongoing operations or "your work', which is the
subject of the written contract or written agreement; or
2. Except at provided in 1. above, if the written contract or written agreement require that you provide that the person
or organization be named as an additional insured such party is an additional insured only to the extent that
"bodily injury" "property damage" or "personal and advertising injury" is caused, in whole or in part by,
a. Your acts or omissions; or
b. The acts or omissions of those acting on your behalf,
in the performance of your ongoing operations or "your work' which is the subject of the written contract or written
agreement;
However, the insurance afforded to such additional insured:
1. Only applies to the extent permitted by law
2. Will not be broader than that which you are required by the written contract or written agreement to provide for
such additional insured;
3. Only applies if the "bodily injury", "property damage" or "personal and advertising injury" occur subsequent to your
execution of the written contract or written agreement; and
4. Does not apply to "bodily injury" or "property damage" caused by "your work' and included within the "products -
completed operations hazard" unless the written contract or written agreement specifically requires that you
provide such coverage. If the minimum time period for providing such coverage in the written contract or written
U-GL-1114 A CW 1002
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