HomeMy WebLinkAbout406545 ENCORE ELECTRIC INC - INSURANCE CERTIFICATEPSNrN�3%0117
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Q Aco c� CERTIFICATE OF LIABILITY INSURANCE o: 9/22D° o"
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.
H SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on
this cerlificate does not confer rights to the certificate holder in lieu of such endoraerne s .
PRODUCER 1-800-247-7756 A
NAME:
Holmes Murphy 6: Assoc — WDK PHONE FAX
N
PO Box 9207ADDRESS:
INSURERS AFFORDING COVERAGE NAIC0
Dee Moines, IA 50306-9207 INSURER A: ZURICH AMER INS CO 16535
INSURED INSURERS: TRAvsLSRS PROP CAB CO OF AMOR 25674
Hncore Electric, Inc.
INSURER C :
7125 V. Jefferson Avenue, Suite 400 INSURER D:
INSURERE:
Lakewood, CO 60235 INSURERF:
CnVFRArAFS CFRTIFICATF MthMRFR- 50124314 RFVISM71114 MIIMRFR-
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.
LTR
TYPE OF INSURANCE
POUCYNUMBER
POMLCYEFF
POLICY EXPmonlm (mum.
umn's
A
E
COMMERCULLGENERALLIABanY
GWI125116
05/01/20
05/01/21
EACHOCCURRENCE
S 1,000,000
CLAIMS -MADE 7X OCCUR
PREMISES e oeamenwl
S 100,000
MED.EXB one rear)
S 10,000
PERSONAL 4 ADV INJURY
$ 1,600,606
GENLAGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE.
$ 2.000,000
POLICY ff] JEPRO-
CT LOC
-
PRODUCTS-COMP/OP AGO
$ 2,000,000
_ _ _
_
.OTHER: -
.. __
. -.....
A
AUTOM61BILELJABIUTf
BAP1125117
05/01/20
05/01721
-COMSI D IN_ LEU I (Ea moddent)$
1, 000, 000
BODILY INJURY (Per pereon)
$
Y
.ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS.
BODILY INJURY (Per aorMed)
$
PROPERTY DAMAGE
S
E
HIRED E NON -OWNED
AUTOS ONLY AUTOS ONLY
s
H
%
I UMBRELLA UAS
E
OCCUR
ZOP-16N39815
01/01/20
03/01/21
EACH OCCURRENCE
S 22,000,000
AGGREGATE
: 22,000,000
EXCESS LUUI
CLAIMS -MADE
.DED. RETENTIONS
$ _
A
WORNERSCOMPENSATION
AND EMPLOYERS' LIABILRYIN V
ANYPROPRIETORIPARrNERIE)ECUTNE
OFFICERIMEMBEREXCLUDED7
(MMIslary In NM)
NIA
WC112115
05/01/20
-STATUTEE
OS/01/21
E PER ORH-
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE -EA EMPLOYE
$ 1,000,000
-
8 yyeese desal6e under
DESCRIPTION OF.OPERATIONS bebw.
El. DISEASE -POLICY LIMB
f 1,000,000 ,
DESCRIPTION OF OPERATIONS) LOCATIONS I VEHICLE$ (ACORD 101,AddMenel ROmeAe
Schedule, mey be a:taehed It more spew Is required)
RE: RFP 8667 Arch Plash Analysis. City of Port Collins
is an additional insured on general liability and automobile
liability if required by written contract. If the liability
Policies are cancelled by the issuing companies, 30 days
notice will be provided to the certificate holder.
-
ty of Port Collins
.0. Box sea
art Collins„ CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE MIPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS..
USA I J L '4"'7 'D
01988.2015 ACORD CORPORATION. All rights reserved.
ACORO 25 (2078103) The ACORD name land logo are registered marks of ACORD
chellmaaxdsm
59124314
N
7
z
Lu
Additional Insured — Automatic — Owners, Lessees Or
Contractors
ZURICW
Policy No.
Eff. Date of Pol.
Exp. Date of Pol.
Eq. Date of End.
Producer No.
Add'I. Prem
Return Prem.
GLO1125116
05/01/2020
05/01/2021
05/01/2020
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
Named Insured:
Address (including ZIP Code)
This endorsement modifies insurance provided under the:
Commercial General Liability Coverage Part
A. Section II — Who Is An Insured is amended to include as an additional insured any person or organization whom you
are required to add as an additional insured on this policy under a written contract or written agreement executed by
you but only with respect to liability for "bodily injury", "property damage" or "personal and advertising injury" if:
1. The written contract or written agreement specifically requires that you provide that the person or organization be
named as an additional insured under the Insurance Services Office (ISO) ISO CG20 10 10/01 edition or the ISO
CG20 37 10/01 edition, then such party is an additional insured only to the extent that "bodily injury" "property
damage" or "personal and advertising injury" arises out of your ongoing operations or "your worn', which is the
subject of the written contract or written agreement; or
2. Except at provided in 1. above, if the Written contract or written agreement require that you provide that the person
or organization be named as an additional insured such party is an additional insured only to the extent that
"bodily injury" "property damage" or "personal and advertising injury" is caused, in whole or in part by,
a. Your acts or omissions; or
b. The acts or omissions of those acting on your behalf,
in the performance of your ongoing operations or "your work" which is the subject of the written contract or written
agreement;
However, the insurance afforded to such additional insured:
1. Only applies to the extent permitted by law
2. Will not be broader than that which you are required by the written contract or written agreement to provide for
such additional insured;
3. Only applies if the "bodily injury", "property damage" or "personal and advertising injury" occur subsequent to your
execution of the written contract or written agreement; and
4. Does not apply to "bodily injury" or "property damage" caused by 'your work" and included within the "products -
completed operations hazard" unless the written contract or written agreement specifically requires that you
provide such coverage. If the minimum time period for providing such coverage in the written contract or written
U-GL-1114 A CW 1002
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