HomeMy WebLinkAboutUTILITY PARTNERS OF AMERICA LLC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY)
3/29/2019
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
Assurance Agency, Ltd NAME: Adam Owens
1750 E Golf Road PaHic"r o 847 463-7834
FAX No : 847 440-9126
Suite 1100 E-MAIL
ADDRESS: aowens assurances enC .com
Schaumburg IL 60173 INSURrRtS1 AFFORIDING COVERAGE NAIC#
INSURER A: Endurance Assurance Corporation 11551
INSURED Utility Partners of America, LLC INSURER B: Navigators Specialty Insurance 36056
7600 Pelham Road, Ste B INSURERC: Phoenix Insurance Company 25623
Greenville SC 29615-5736 INSURERD: The Travelers Indemnity Com an 25658
INSURER E: Travelers Casualty & Suret Co 31194
INSURER F
COVERAGES .. �. .. ...... ... ...�__
vV� I�V111 LiLR.
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 INSURANCEINSD
ADDL SUBR
WVDPOLICY
NUMBER
MM/DD/YYYY
EXP -
MM DD/YYYY LIMITS
C
X
I COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
66051<556461
4/1/2019
4/1/2020
EACH OCCURRENCE
$1,000,000
PREMISES Ea occurrence
$ 1,000,000
MED EX P (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
JPRO-
POLICY LOC
OTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OP AGG
$ 2,000,000
$
D
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
8105K41569A
4/1/2019
4/1/2020
Ee aBcid DiSINGLE LIMIT
$ 1,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
-DAMAGE
$
PROPERTY
Per accident
$
$
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
UMB30000062503
4/1/2019
4/1/2020
EACH OCCURRENCE
$ 25,000,000
AGGREGATE
$ 25,000,000
DED X RETENTION $
$
E
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
UB7K372391
4/1/2019
4/1/2020
X PER OH -
STATUTE ER
E.L.OFFICER/MEMBER EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
B
Excess Auto Liability
CH19EXC9257341C
4/1/2019
4/1/2020
Occurrence
1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Proof of Insurance.
It is agreed that City of Fort Collins is Additional Insured, when required by written contract, on the General Liability and Automobile Liability with respect to
operations performed by the Named Insured in connection with this project.
City of Fort Collins
222 Laporte Ave.
Fort Collins CO 80522
CL-PA 11Vry
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
U 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD