HomeMy WebLinkAboutECKSTINE ELECTRIC CO - INSURANCE CERTIFICATEACCW?" CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDD/YYYY)
11I
06/21 /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 Valerie Love, CIC, CISR
NAME:
Flood and Peterson
PHONE (g70) 356-0123 FAX (970) 330-1867
/C No Ext : AlC, No
(A/C.
PO Box 578
E-MAIL VLove@FloodPeterson.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Travelers Indemnity Company
25658
Greeley CO 80632
INSURED
INSURER B : Charter Oak Fire Insurance Company
25615
Eckstine Electric Co.
INSURER C : Travelers Property Casualty Company of America
25674
13739 Cr 25 1/2
INSURER D : Pinnacol Assurance
41190
INSURER E :
Platteville CO 80651
INSURER F :
COVERAGES CERTIFICATE NUMBER: 2019-2020 Master 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.
INSR
LTR
TYPE OF INSURANCE
ADDLSUBR
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ❑X OCCUR
EACH OCCURRENCE
$ 1,000,000
A
PREMISES Ea occurrence
$ 300,000
MED EXP (Anyone person)
$ 10,000
PERSONAL &ADV INJURY
$ 1,000,000
A
4TC01558X1951ND19
01/01/2019
01/01/2020
GEN'L AGGREGATE LIMIT APPLIES PER:
X PRO
POLICY ❑ LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS-
2,000,000
$
$
OTHER:
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
X
ANYAUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
4T8101558X195TIL19
01/01/2019
01/01/2020
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
Underinsured motorist
$ 1,000,000
UMBRELLA LIAR
OCCUR
—... ". — V .1,. """'
EACH OCCURRENCE
11,000,000
$
C
EXCESS LIAB
CLAIMS -MADE
CUP-OK267096-19-2S
01/01/2019
01/01/2020
AGGREGATE
$ 11,000,000
DED I X1 RETENTION $ 10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBEREXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
4153710
07/01/2019
07/01/2020
X1 STATUTE ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Building Inspection Department
ACCORDANCE WITH THE POLICY PROVISIONS.
P O Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522-0000
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