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HomeMy WebLinkAbout114215 MERIT ELECTRIC INC - INSURANCE CERTIFICATE (8)A/C�RO® `./ CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 07/01/2019 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 Jennifer Winter, CISR NAME: Flood and Peterson ti/C N Ex : (970) 506-3206 Fvc No): (970) 506-6846 E-MAIL JWinter@floodpeterson.com ADDRESS: PO Box 578 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Union Insurance Company of Providence 21423 Greeley CO 80632 INSURED INSURER B : EMCASCO Insurance Company 21407 INSURER C : Employers Mutual Casualty Company 21415 Merit Electric, Inc. INSURER D : Pinnacol Assurance 41190 2590 Midpoint Drive INSURER E : INSURER F : Fort Collins CO 80525 rnvcoer_cc r FRTIFIr_ATF NI IMRFR• CL197130177 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 CONTRACTOR 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. IPOLICY LTR TYPE OF INSURANCE INSVD D W POLICY NUMBER MMIDDLICYIYYYY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY 5�7, CLAIMS -MADE OCCUR PD Ded:5,000 6DO735920 07/01/2019 07/01/2020 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTE17- PREMISES Ea occurrence $ 500,000 X MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 1IJECT PRO � LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANYAUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY X DOC 6EO735920 07/01/2019 07/01/2020 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 6JO735920 07/01/2019 07/01/2020 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED I X1 RETENTION $ 0 $ D WORKERS COMPENSATION EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE� (Mandatoryin N ER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4070414 07/01/2019 07/01/2020 PER PR !7 STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE -POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: License #AS-1577 11,919 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 281 N. College Avenue AUTHORIZED REPRESENTATIVE Fort Collins CO 80524 ©1988-2015 ACORD CORPORATION. All ngnts reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD