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HomeMy WebLinkAboutENERGES SERVICES LLC - INSURANCE CERTIFICATEAa 71,3/29/2019 E (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 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 CONTACT AssuredPartners Colorado P"ONt: ---- FAX - — 4582 S. Ulster St., Suite 600 : 303-863-7788 wc. Noi:303-861-7502 Denver CO 80237 AMAIES : APCO360 assured trco.com INSURER(s) AFFORDING COVERAGE INSURER A: St Paul Mercury Insurance Co 24791 INSURED ENERSER-01 INSURER B : Plnnacol Assurance 41190 Energes Services LLC _ ___.____- 1328 East 18th Street -INSURER C: Federal Insurance Compeny —. __— — 20281_ Greeley CO 80631 INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:70021 oo REVISION NUMBER: 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. — .... R — ' �- --- '-- ISUBR� POLICV EFF POLICY EXP ILT R TYPE OF INSURANCE N DL POLICY NUMBER MM/DD/YYYY MM 0/YYYY LIMITS A X i COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Y Y ZLP71M24466 411/2019 :; 4/1/2020 EACH OCCURRENCE _PRME ACE -TO RENTED (fig ocyurr@ny4j_ $1,000,000 000 $100 $100, $ 5 000 S/A POLLUTION MED EXU�ny one parsons PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: $ 2,000,000 GENERAL AGGREGATE POLICY JE C LOC PRODUCTS - COMP/OP AGG _ $ 2,000,000 _— A AUTOMOBILE LIABILITY Y Y ZLP71110124456 4/1/2019 4/1/2p2000MBINED SINGLELIMIT accident) $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE — Per accid@nJL___—, $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY i A X UMBRELLA LIAB X OCCUR Y Y ZLP71M24466 4/1/2019 4/1/2020 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 EXCESS LIAB L CLAIMS.MADE DED X ! RETENTION $ in,nnn — $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER'EXECUTIVE Y / N OFFICER'MEMBEREXCLUDED? (Mandatory In NH) NIA I Y 4216102 4/1/2019 j 4/1/2020 X STAT ORH- E.L. EACH ACCIDENT a E.L DISEASE _ EA — $1,000,000 $1,000.000 If yes describe under DESCRIPTION OF OPERATIONS below _EMPLOYEE ---- _—� E.L. DISEASE - POLICY LIMIT —. - $ 1,000,000 C Equipment Floater I 6698017 4/1/2019 4/1/2020 Contractor's Equip 11,157,921 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Additional Insured: City of Fort Collins, its officers, agents and employees as required by written contract. lya:lllill�11113iC9lal1 PS3II9JlNL' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 300 Laporte Ave. Fort Collins CO 80522 AUTHORIZED REPRESENTATIVE USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2 of 2 18419