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507242 CUSTOM SOLAR LLC - INSURANCE CERTIFICATE (6)
ACX>Rc r )F LIABILITY INSURANCE DATEM"°°""°' CERTIFICATE 1011812019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND'CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVE Y 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)i AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE i10LDER. IMPORTANT: If the certificate holders an ADDITIONAL. INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and con fitlons of,the policy,. certain policies may require an endorsement A statement on this certificate does not confer rights to.the.certificate holde�lll In lieu of such endorsements ... _-...... ....... _....... ..__.._. _ _ _ PRODUCER Commercial Risk Solutions 6600 E Hampden Ave Ste.200 Denver CO 80224 crim NAME:.- Sandra Tovar PHONE - FAX - 303-996-7801, FAx No.303 757 7719 E-MAIL _._- .. __._ ...... _. _._ ADDRESS: StOVaT CrSdenver.Com INSURE S AFFORDING COVERAGE NAIC It INSURER A: Westfield Insurance 24112 INSURED COSTS-2 INSURER$:. PlnnaCol ASSuranCe - 41190 Custom Solar LLC 2840 Wilderness Place, Ste F INsuRERc: Boulder CO 86301 INSURER 0: I INSURER E: INSURER F: CR1VFRArFS CFRTIFICATE NUMRERt111RRn01RR7 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 DOCUMENTIT 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 BEENREDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE - __.. A SUB WVO ..I ... _.. POUCYNUMBER POIJCYEFF MMlODNY .POLICYEXP MMID NY VAS .. A X COMMERCIAL GENERALWUBILn-.Y Y CV00126513 1.1/1.0/2019 111102020 EACH OCCURRENCE $1,000,000 CLAIMS -MADE. I OCCUR I DAMAGE TO RENY150 PREMISES Ea'ocarnence $.500,000 MED EXP (Any one person) $ 5,000 PERSONAL BADV' INJURY $1.000,000 GEN-L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2:000,000 %( POLICY IK JECT 7 LOC PRODUCTS -COMP/OP.AGO $2,000,000 $ OTHER: 'A AUTOMOBILEUABIU[TV CVVP012651 11/102019 111101202O COMBINED SINGLELIMIT$1,000,000, Ea accident BODILY INJURY(Perperson) $ X ANY AUTO 7 OWNED SCHEDULED ON .AUTOSXHIRED BODILY INJURY(Peraccident) $ PROPERTYDAMAGE Per accitlera] $ _ HAUTOSIRED NON -OWNED NED. AUTOS ONLY AUTOS ONLY N $ X OCCUR CV00126511 11/102019 11/162020 EACH OCCURRENCE $1,000.000 AGGREGATE $1.000,000 A I �RETENTINg CLAIMS -MADE MB X $ . B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER RIETOFUPARTN R(E ECUTIVE Yy (Mandatory. in NH) N1A 4160311 12/12019 12/12020 X -O H= STATUTE ER. E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1;000,000 - - if yyes. describe under DESORIPTION OF OPERATIONS below- — - - - —. �- -- -- - -I - ----- — —.___._._.. .— ... —.- I.E.L. DISEASE- POLICY. LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / YEHILER (AGGRO 101, Additional Remarlre schedule, may tie.attaehed 11 mprespabe Is, required) Certificate Holder is included as additional.insured on the General Liability with respect tO:ongoing operations of -the named insured for the certificate holder as required by written contract. All policy.terms, conditions and exclusions apply. CERTIFICATE HOLDER I CANCELLATION SHOULD ANY OF THEABOVE DESCRIBED POUCIES.BE CANCELLED BEFORE. I THE EXPIRATION DATE THEREOF, 'NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins 215 North Mason Street2nd floor Fort Collins C0:80524 AUTHORIZED REPRESENTATIVE 7 ©1968-2015 ACORD CORPORATION. Ail rights reserved. ACORD 25 (201fi/03) The ACORD nam and logo are registered marks of ACORD 2' of 2 6228