HomeMy WebLinkAboutROY'S ELECTRIC INC - INSURANCE CERTIFICATE (2)CERTIFICATE
OF LIABILITY INSURANCE
American
Family Insurance Company
American Family Mutual
Insurance Company if selection box is not checked.
6000 American
Pky Madison, Wisconsin 53783-0001
Insured's Name and Address
Agent's Name, Address and Phone Number (Agt./Dist.)
Roy's Electric Inc
Yesenia Salomon
1610 Pace St. Unit 900-439
917 S Main St Ste200
Longmont, CO 80501
Longmont, CO 80501
(303) 485-0745 (034/309)
This certificate is Issued as a matter of information only and
confers no rights upon the Certificate Holder.
This certificate does not amend. extend or alter the coverade
afforded by the oolicies listed below.
This is to certify that 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 pollees described herein is subject to all the terms, exclusions, and conditions of such policies.
POLICY DATE.
TYPE OF INSURANCE
POLICY NUMBER
LIMITS OF LIABILITY
E C IDATION
blo rXo
Homeowners/
Bodily Injury and Property Damage
Mobilehomeowners Liability
Each occurrence $ '000
BOatOWnefe Liability
Bodily injury and Property Damage
Each Occurrence $ '000
Personal Umbrelta Liability
Bodily Injury and Property Damage
_
Each Occurrence ,000
-
Farts Liability 3 Personal Liability
Farrn/Ranch Liability
Each occurrence $ '000
Fans Employer's Liability
Each Occurrence $ ,000
_ _
Statutory
Each Accident $ '000
Workers Compensation and
Employers Liability t
Disease -Each Employee $ '000
Disease -Policy Limit $ '000
General Liability
General Aggregae $ 000
Products -Completed Operations aggregate $ '000
❑ Commercial General
Personal and Advertising Injury -$ _ - _,000.
Liability (occurrence)
❑
Each Occurence $ '000
❑
Damage to Premises Rented to You $'000
Medical Expense (Any One Person) _ _$_ _ - ,000
Each Occurrencett $
Businessowners Liability
'000
Aggregateitt $ ,000
Liquor Liability
Common Cause Limit $ 000
Aggregate Limit $ 1000
Automobile Liability
BodilyInjury - EachPerson $ 2,000,000
❑ Any Auto
❑AIIOwnedAutos
Bodily Injury - Each Accident $ 2,000,000
Property Damage $ 2,000,000
NI Scheduled Autos
05-XH2153-03
03/05/2020
03/05/2021
❑ Hired Auto
Bodily Injury and Property Damage Combined $ '000
❑ Nonowned Autos
13
Excess Liability
❑ Commercial Blanket Excess
Each Ocetmence/Aggregate $ '000
Other (Miscellaneous Coverages)
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 RESTRICTIONS I
SPECIAL ITEMS tThe individual or Partners ❑ Have
shown as insured elected to
be covered under this policy..❑ Have not
ttProducts-Completed Operations aggregate
Is equal to each occurrence limit and Is
included in policy aggregate.
_ ,._
_ _CERTIFICATE HOLDERS NAME AND AD_ DRE
s',
_.
_ vCA..NCELLATION _ .<_ _ _ I
City Ft Collins
LJ Should any of the above described policies be cancelled before the expiration date
of
thereof, the company will endeavor to mall'( days) written notice to the Certificate
300 LaPorte Ave
Holder named, but failure to mall such notice shall Impose no obligation orliability of any kind
*10
uponthe company, its agents or representatives. days unless different number of days
Ft Collins, CO 80524
shown.
LxJ This certifies coverage on the date of laws only. The above described policies are
subject to cancellation in conformity with their terns and by the laws of tha up.
DATE ISSUED
AUTHORIZED REPRESE
07 I#
YESENIA SALO oN
U-201 Ed. 6100
Stock No. 06668 Rev. 7/02