HomeMy WebLinkAboutC&R ELECTRICAL CONTRACTORS - INSURANCE CERTIFICATEA`oRbr CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)
06/09/2020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELNlAMEND, 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 ADDITIONALINSURED-provisions or be endorsed. -
If SUBROGATION IS WAIVED, subject to the terms and cond' Mons of the policy, certain policies may require an endorsement. A statement on
this certificate does not confer rights to the certificate holder. in.lisu of such endomement(s)•:
PRODUCER .MANE: Jody Hama
Brown & Brown of Colorado, Inc. PHONE (970) 4827747 A� Ne : (970) 484-4165
4532 Boardwalk Dr., Suite 200 L certificates@bboolorado.00m
.ADDRESS:
INSURER(S) AFFORDING COVERAGE NAICA
Fort Collins CO 80525 INSURERA;. WestriekilnsuranceCompany 24112-
INSURED INSURERB: PinnacolAssuranee 41190
C&R Electrical Contractors
10475 Irma Or Unit 13
Northglenn CO 80233 I INSURER F:
rmirewr_ec rewlclrAT ultsameCJ 20-21 Master DimnctInu ui1MRPR•
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW
HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD - - -
WICONDITION
INDICATED. NOTWITHSTANDING ANY REQUIREMENT TERM OR C
NDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
EXCLUSIONS AND CONDITIONS OF SUCH. POLICIES. LIMITS SH64
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE1ERMS,
MAY _HAVE. BEEN REDUCED BY PAID CLAIMS.
-.
LTR
TYPE OF INSURANNSR CE
(POLICY NUMBER
MM
MMID
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
E 1,000,000
CLAIMS -MADE ® OCCUR
DAMAGhjQ
PREMISES Ea=o unoe
E 500,000
MED EXP one
E 5,000 _
A
CWP7604548
07/01/2020
07/01/2021
PERSONAL aADvlwuRv
E 1,000000
GEN'_LAGGREGATE UMITAPPUES PER:
GENERALAGGREGATE
E 2,000,000
POLICY 19 JEC7 M LOC
PRODUCTS
5 2,000,000
E
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
E 1,000,000
BODILY INJURY (Oar Person)
E
ANYAUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
CWP78
548
07/Ot/2020
07I01/2021
eODILV INJURY (Par accident)
_- -
E -
PROPERTY DAMAGE
Per accident
b
E
_
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
E 1,000,000
AGGREGATE
E 1,000,000
A
EXCESS UAB
CUUMSMADE
CWP7604548
07/014020
07/01/2021
DEC I X RETENTION.$ 0
E
e
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE YIN
OFFICERMIEMBEREXCLUDED?
(Mandatory In NM) — _
NIA
4202797
07/01/2020
07/01/2021
- -PER 'OTH=
STATUTE ER
_. - -__-
.E.L.EACH ACCIDENT
E 500,000
E:LDISEASE• EA EMPLOYEE
E 50C,000.
E.L.DISEASE • POLICY OMIT
E 500,000
If yea, deavme under
DESCRIPTION OF OPERATIONS below
A
Property
CWP76
4548
07/01/2020
07/01/2021
Leased/Rented Equip
$75,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Addidor,`I
Remadra Schedule, may be attached a more span Is required)
RE: Contractor License # ME- 05
r015tlorAz u/V RGn I rAurCI I A"nu
SHOULD ANY OF THE ABOVE_ DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Bldg. Dept.
ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 580
AUTHOROM REPRESENTATIVE
Fort Collins CO
80522-0580
C✓7708•W IO NVVRY irVRrVRM11VR. /ill RgRRMiIVifRrrYtl0.
ACORD 25 (2016163) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID:
LOC A:
A�� ADDITIONAL REMARKS SCHEDULE Page of
The ACORD name and logo are registered marks of ACORD