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HomeMy WebLinkAboutMOONLIGHT ELECTRIC INC - INSURANCE CERTIFICATEq� �® CERTIFICATE OF LIABILITY INSURANCE DATE 6/21/2019 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 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: Richard Marchesini(0717310) PH1C. No.ONE 303-969-9287 ac No): 303-969-8007 3900 S Wadsworth Blvd Ste 365 nnoRFss• rmarrhesiniafarmersanent rnm Lakewood CO 80235-2220 MOONLIGHT ELECTRIC INC 26731 WELD COUNTY ROAD 18 INSUREII Truck Insurance Exchange 21709 INSURER B : Farmers Insurance Exchange 21652 INSURER C: Mid Century Insurance Company 21687 KEENESBURG CO 80643 INSURERF: COVFRAGFS 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 LTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 CLAIMS -MADE OCCUR MED EXP (Any one person) $ 5,000 PERSONAL a ADV INJURY $ 1,000,000 C Y N 604833002 06/16/2019 06/16/2020 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acadant $ _-_ 1,000 000 BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ C ALL OWNED SCHEDULED X AUTOS AUTOS 604833002 06/16/2019 06/16/2020 PROPERTY DAMAGE Peraccident $ NON -OWNED HIRED AUTOS AUTOS U�BRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A ES LIAB CLAIMS -MADE 604833020 06/16/2019 06/16/2020 X :RETENTION $ 10,000 $ WORKERS COMPENSATION WC STATU- OTH- TOR S1ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 26731 WELD COUNTY ROAD 18, KEENESBURG, CO 80643 l.tK I Wlt A I t MULL t:K UAINk r-LLA I IUIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF FORT COLLINS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 21 NORTH COLLEGE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE FORT COLLINS CO 80522 RICHARD MARCHESINI, LUTCF ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD