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HomeMy WebLinkAboutKELLY ELECTRICAL SERVICES INC - INSURANCE CERTIFICATEA�CO�R" CERTIFICATE OF LIABILITY INSURANCE FDATE (MM/DD�YYYY) 6/27i2019 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 NAME: Sandra TOVar Commercial Risk Solutions 6600 E Hampden Ave Ste 200 _ PHONE FAX • 303-996-7801 A/c No): 303-757-7719 ADDRESS: stovar crsdenver.com Denver CO INSURERS AFFORDING COVERAGE NAIC # INSURER A: Continental Western Ins Co. 10804 INSURED KELLY-1 INSURER B : Pinnacol Assurance 41190 Kelly Electrical Services Inc. � � 11437 West 1-70 Frontage Road INBURERC: --� INSURERD: I Wheat Ridge CO 80033-2101 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER:1268967209 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 TYPE OF INSURANCE AD L, U POLICY EFF POLICY EXP LIMITS TR POLICY NUMBER MMID MMUD/YYY A COMMERCIAL GENERAL LIABILITY CLAIMS MADE E OCCUR j CPA3032888 7/1/2019 7/1/2020 EACH OCCURRENCE PR�MISES�(��„gC�rrgttFel $ $ _ _ MED EXP_jAny onelerson) $ _ l PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ __-.. POLICY JE 4 �� LOC PRODUCTS - COMP/OP AGG $ $ OTHER: A AUTOMOBILE LIABILITY CPA3032888 7/1/2019 7/1/2020 1COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) -}-$ BODILY INJURY (Per accident) I $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY j PROPERTYOAMAGE�� LP�t��C�31_ $ $ A X _ UMBRELLA LIAO X 'OCCUR CPA3032888 7/1/2019 7/1/2020 EACH OCCURRENCE $5,000,000 AGGREGATE $ EXCESS LIAR CLAIMSMADE DED X ' RETENTION $ „ _ $ B WORKERS COMPENSATION 4124586 7/1/2019 7/1/2020 X PER1 OTH- STAT�ITE-L-- AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNERlEXECUTIVE -j -ER ,- E.L, EACH ACCIDENT $1.000,000 OFFICER/MEMBER EXCLUDED? ❑ N!A --- - E.L. DISEASE - EA EMPLOYEE -- $1,000,000 (Mandatory In NH) If yes. describe under DESCRIPTION OF OPERATIONS below _._.._...-.._..._-__.___.._._,..-._�_,._....._.. E.L. DISEASE - POLICY LIMIT �.._..___ ...._-....-_.__._____.. $ 1.000,000 i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks schedule, may be attached it more space is required) All policy terms, conditions and exclusions apply. HOL City of Fort Collins 281 N. College Avenue Fort Collins CO 80522 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 3 of 3 17572