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Home My WebLink AboutMASUN ENERGY SYSTEMS INC - INSURANCE CERTIFICATEMASUENE-01 MHOFF ACORO CERTIFICATE OF LIABILITY INSURANCE DATE711/2 DlYYYY) /112019 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 License # 0757776 HUB International Insurance Services (COL) 1125 17th Street, Suite 900 CO 80202 CONTACT Barb Arnold AM PH/C No, Ext): (303) 252-3761 FAX, No):(866) 243-0727 (Denver, E-MAIL RE .. Barbara.arnold@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Liberty Mutual Insurance Company 23043 INSURED INSURER B : Plnnacol Assurance Company 41190 INSURERC: Masun Energy Systems, Inc. INSURER D : 308 Summit View Drive Fort Collins, CO 80524 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I X OCCUR X X BKS59784809 6/30/2019 6/30/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PIRMI a occu rence 100,000 $ MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑X PRO- 17 LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X X BKS59784809 6/30/2019 6/30/2020 COMBINED SINGLE LIMIT a accident 1,000,000 $ X BODILY INJURY Perperson) $ BODILY INJURY Per accident $ X PROPERTY DAMAGE Per acC dent $ A X UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE US059784809 6/30/2019 6/30/2020 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED FX RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYY/N ANY PROPRIETOR/PARTNER/EXECUTIVE 7 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A X 4009414 7/1/2019 7/1/2020 X PER OTH- AT TE R 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 / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as additional insured under General Liability. City of Fort Collins P.O. Box 580 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 ACORD 25 (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD