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HomeMy WebLinkAboutPETERSON ELECTRIC LLC - INSURANCE CERTIFICATE (3)DATE (MM/DDIYYYY) ACORD® CERTIFICATE OF LIABILITY INSURANCE 1 05/13/2019 r 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 A M A N D A B U R C H E T T NAME , MOODY INS AGENCY INC 8055 E TUFTS A V E S T E 1000 PHONE FAX (A/C, C, No. Ext) 888 793-1481 A/C No): 800 974-0297 AIL ADDRESS SERVICECENTER UNITEDFIREGROUP.COM PRODUCER DENVER CO 80237 CUSTOMER ID#: INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER United Fire & Casualty Com 13021 INSURERB. PETERSON ELECTRIC LLC INSURER C INSURERD: 2355 CALCITE ST INSURERE. LOVELAND CO 80537-2004 INSURER F. rnvronr_oe rceTIPIreTF RFVISIt7N 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 DDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MMIDDIYYYY LIMITS A COMMERCIAL GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE � OCCUR N N 60350023 07/07/2019 07/07/2020 EACH OCCURRENCE 1,000 00 DAMAGE TO RENTED PREMISES Ea occurrence 100 , OO $ 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 , 000 , OO $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS N N 60350023 07/07/2019 07/07/2020 COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ X PROPERTY DAMAGE (Per accident) $ $ UMBRELLA UAB EXCESS LIAR 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 I OTH- IER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES (ACORD 101, Additional Remarks Schedule, if more space is required) CFRTIFICOTF HOI DFR 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 BOX 580 WITH THE POLICY PROVISIONS. FORT COLLINS CO 8 0 5 2 2— 0 5 8 0 AUTHORIZED REPR ENT/ _ A*oa ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD © 1988-2014 ACORD CORPORATION. All rights reserved.