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HomeMy WebLinkAboutSIMPSON ELECTRIC INC - INSURANCE CERTIFICATE (11)CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �..� 3/16/2019 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 CONTACT TrueNorth Companies, L.C. NPHAONE — RM Longmont FAX _ ------ 275 S. Main St Suite 100 • 303-776-5122 Arc No:303-776-5495 Longmont CO 80501 ADDRESS: long montsm truenorthcom anies.com INSURER(S) AFFORDING, COVERAGE NAIC x - — IC ---- ___ INSURER A: Owners Insurance Company 32700 INSURED sIMPELE-01 INSURER B`Auto-Owners Insurance Company + 18988 Simpson Electric, Inc INSURER Pinnacol Assurance 41190 P. O. Box 2196 -- -- Loveland CO80539 INSURERD: INSURER E : INSURER F : COVERAGES CERTIFICATE NIIMRFRc2n952TF31q RFVISInN NIIII 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. LTR TYPE OF INSURANCE INS13 wV0POLICY NUMBER MMMD/YYYY MM/DD/YYYY LIMITS A X -i COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [� OCCUR Y 74144089 4/1/2019 4/1/2020 EACH OCCURRENCE $1,000,000 Alal" Ta-REF17El�--_._.- Rf[yIIS_i�,�4Sd7.1�Q�4St).__ - ----------._ $300,D00 MED EXP (Any onrton) _ $10,000 PERSONAL 8 ADV INJURY_ $ 1,000,000 GEN'L %( 1-1 AGGREGATE LIMIT APPLIES PER: POLICY JEC LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -_COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY 4268565900 4/1/2019 4/1/2020 COMBINED SINGLE LIMITi AEsX $1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED X AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY _! AUTOS ONLY 'BODILY INJURY (Per accident) _ PROPERTY DAMAGE (Pgr�SlgnO _ $ $ $ 3 X UMBRELLALIAB 1 X OCCUR 4268565901 4/1/2019 4/1/2020 EACH OCCURRENCE $1,000.000 AGGREGATE $1,000,000 — EXCESS LIAB CLAIMS -MADE DED - ' RETENTION $ _ _ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA 4182129 4/1/2019 I 4/1/2020 X PER TH- T T R E.L. EACH ACCIDENT _ $ 1,000,000 _ ----- E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes. describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS : LOCATIONS i VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) I t lr1ULUtK City of Fort Collins Attn: Laurie P.O. Box 580 Fort Collins CO 80522 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. REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2' of 2 4979