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Home My WebLink About114215 MERIT ELECTRIC INC - INSURANCE CERTIFICATE (9)AC� ® C" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 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 Flood and Peterson NAME: CONTACT Jennifer Winter, CISR PHONE (970) 506-3206 FAX (970) 506-6846 (AICN Ex A/C No 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 nAr_0c /`CDTICIr ATF NI IMRER• 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 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. INTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DDtYYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR PD Ded:5,000 6DO735920 07/01/2019 07/01/2020 EACH OCCURRENCE $ 1,000,000 PREMISES OER a occurrence $ 500,000 X MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY � PRO-ECT FX LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ B AUTOMOBILE LIABILITY(Ea 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 COMINED accidentSINGLE LIMIT $ 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 AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4070414 07/01/2019 07/01/2020 H X STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,00 E.L. DISEASE - POLICY LIMIT -'000 $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) C m1 IVIr SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins Light & Power ACCORDANCE WITH THE POLICY PROVISIONS. 700 Wood Street AUTHORIZED REPRESENTATIVE Fort Collins CO 80525 Ce� V lytftf-ZUTJ AI.VKU t.VRrVRr+I IVIv. hu nynw reaer r�u. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD