HomeMy WebLinkAbout193498 E-CUBE INC - INSURANCE CERTIFICATE (2)Client#: 98325
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MMrDO YYYY)
8/23/2019
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(les) 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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
CBIZ Insurance Services, Inc.
700 West 47th Street, Suite 1100
Kansas City, MO 64112
816 945-5500
INSURED
Nederland Refrigeration. Air Conditioni
ng & Heating Corp., dba E-Cube Inc.
1720 Topaz Dr.
Loveland, CO 80537
Laura Weeks
n: 816-945-55f
INSURER(S) AFFORDING COVERAGE
NAIC i
INSURER A: Hartford Casualty Insurance Co
29424
INSURER B : Hartford Insurance Co. of the Midwest
137478
INSURER C : Travelers Casualty & Surety Co. of Am.
131194
INa tocn n . Hartford Underwriters ' 30104
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 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.
INSR
LTR
TYPE OF INSURANCE
ADDL
INcJR
UBR
yyyD
POLICY NUMBER
POLICY EFF POLICY EXP
MMDD/YYYY
M0219
UMITs
A
XRCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
37SBAPK5611
09/'09/202 0
EACH OCCURRENCE
s2000000
PREMISES Eaozu£rr0ence
$100 000
MED EXP (Any one arson)
$ 5 000
PERSONAL &ADV INJURY
s2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
X POLICY JECT LOC
OTHER:
GENERAL AGGREGATE
s4 00O OOO
PRODUCTS - COMPIOP AGG
s4 000,000
$
D
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED SCHEDULl71
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY X AUTOS ONLY
37UECKD=
/09/2019
09/09/202
COMBINED SINGLE LIMIT
(Ea a I ent
1,000,000
BODILY INJURY (Per person)
$
X
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
A
X
IIYBRELLA IJAB
IXCESS LIAB
)(
OCCUR
CLAIMS -MADE
37SBAPK5611
37WBCBZ3056
105493136
/09/2019
09/09/202
EACH OCCURRENCE
$5 000 000
AGGREGATE
_
$5 000 000
DED I X RETENTION $1O 000
X PER OTH-
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITYFR ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED? F
(Mandatory In NH)
tl yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
9/09/2019 09/09/202
E.L. EACH ACCIDENT
$1 O00 OOO
E.L. DISEASE - EA EMPLOYEE
$1 O0O WO
E.L DISEASE - POLICY umrr
$1 0D0,0D0
C
Professional Liab
9/09/2019
09/09/202
$2,000,000 Each Claim/
$2,000,000 Aggregate
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Re: 598's City of Fort Collins. City of Fort Collins is an additional insured with regard to General
Liability and Automobile liability, if required by written agreement, per forms SS000080405 and HA99160312.
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
215 N Mason Street, 2nd Floor ACCORDANCE WITH THE POLICY PROVISIONS.
Ft. Collins, CO 80522
AUTHORIZED REPRESENTATIVE
CBIZ Insurance Services, Inc.
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016 03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S2236187/M2217092 OPRK