Loading...
HomeMy WebLinkAboutCOUPER ELECTRIC LLC - INSURANCE CERTIFICATE (6)AC� a DATE (MMrDONYYY) CERTIFICATE OF LIABILITY INSURANCE 9112/2019 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 NAME; RM Longmont TrueNorth Companies L C. -PHONE FAX 275 South Main Street. Suite 100 • 303-776-5122 AdCNo):3198620612 Longmont CO 80501 ADORItss: certs@truenorthcompanies,conn A: Pinnacol Assurance 1 41190 - Couper Electric LLC 1331 Kanemoto Lane Erie CO 80516-6947 COVERAGES CERTIFICATE NUMBER:1344803386 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 --� TVPEOFINSURANCE -_----AODL,SU------- ------ LTR WV POLICY NUA6ER POLI POLICY EXP . MM?JD.+YY LIMITS COMMERCIAL GENERAL LIABILITY -- EACHOCCURRENCE $ PREMISES (Ea occurren. CLAIMS-MADE OCCUR $ _ I MED EXP (Any oneperson) $ _ PERSONAL& ADV INJURY _ $ GENERAL AGGREGATE G_EN'L AGGREGATE LIMIT APPLIES PER: $ PRODUCTS-COMP/OP AGO PRO- POLICY' _ ' JECT LOC � � $ _ OTHER' $ AUTOMOBILE LIABILITY CCMBINEO SINGLE LIMIT $ ANY AUTO BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per itoodent) $ _ HIRED NON OWNEO AUTOS ONLY ` AUTOS ONLY PROPERTYDAMAGE (Per gcpidantl $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE _ $ EXCESS LIAB -J. CLAIMS -MADE DEC RETENTION$ $ A WORKERS COMPENSATION 4089007 AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNEFUEXECUTIVE YIN N/A OFFICER'MEMBEREXCLUDED9 10/1/2019 10/12020 I ,X STATUTE ER $1,000,000 E.L. EACH ACCIDENT (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 11 yes, describe under DESCRIPTION OF OPERATIONS bebw $-1,000,000 E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS : LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space Is required) City of Fort Collins PO 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2' of 2 22293