HomeMy WebLinkAboutNOVOTNY ELECTRIC LLC - INSURANCE CERTIFICATE (4)NOVOT-1
CERTIFICA E OF LIABILITY INSURANCE
10/23/2019
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGAtVELY 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 Iiconditions of the policy, certain Pericles may require an endorsement. A statement on
this certificate does not confer riahts to the certificate holder in lieu of such endorsement(s).
& Brown Inc
oardviralk Dr, Suite 200
Alins, CO 80626
Account
INSURED Novotny Electric LLC
P O Box 98
Laporte, CO Ban
9704.82-7747
Insurance
----- ---- LIN raaMCm.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
MAY HAVE BEEN REDUCED_BY PAID CLAIMS.
INSR
TYPE OF INSURANCE
ADDL
SUB
yOLICY
NUMBER
POLICY.EFF
POLICYEXP
LIMITS
B
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE �X OCCUR
CWP7961490
16123/2019
10/2312020
EACH OCCURRENCE
1,000,000
oAMAG 1RENTED PREMISES ($
500,000
AHED EXP (AnyonePerson)
$ 51000
PERSONAL & ADV INJURY
$ 1,000AOO
GENT AGGREGATE LIMIT APPLIES PER:
POLICY E jea1:1 LOC
OTHER'
-GENERAL AGGREGATE
$ 2,000A00
PRODUCTS - COMP/OP AGG.
$ 2,000,000
-
B
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUpT�OpSyyryEp
AUTOSONLY AUTOS ONLY
CWP7961490
I
_ _
10/23/2019
_ _
10/23/2020
(Ea accident) COMBINED SINGLE LIMIT
$ 1,000,000
BODILY INJURY' Per Person)$
BODILY INJURY Per accident
$
PROPERTY AMAGE
Pe acatleM
B
UMBRELLA LIAB
EXCESS IJAB
OCCUR
CLAIMS -MADE
CWP7961490
10/23/2019
10123/2020
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$ 1,000,000
DED I X I RETENTION $ 0
A
WORKERS COMPENSATION
AND EMPLOYERS LIABILITYYIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
EXCLUDED?
oA '»ram In
N yes, describe under
DE RIPTION OF OPERATIONS belay
NIA
177813
-
10/01/2019
10/01 /2020
-
-X -PER" -
OTH=
-
E.L. EACH ACCIDENT
500,000
E.L. DISEASE -EA EMPLOYEE
SOO,000
E. - P I Y L
500,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101. AddRlor®I
_. _ -
FAX: 970-224-6134
Remarks Schedule, may be attached if more space Is required)
v
CITYFC2
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
PO Box 580
Fort Collins, CO SO522
-
AUTHORIZED REPRESENTATIVE
House Account
ACORD 25 (2016/03) U 19SB-2U15 AGVKU GUKFL KA I IUN. An agars reserVeo.
The ACORD name and logo are registered marks of ACORD