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HomeMy WebLinkAboutPOWELL INDUSTRIES INC - INSURANCE CERTIFICATE (3)ACORO® DAT 0(5121/2020 CERTIFICATE OF LIABILITY INSURANCE 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 NOTIN I CONSTITUTE A CONTRACT BETWEEN THE ISSUING SURER(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. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER AOn Risk services Southwest, Inc. Houston TX office 5555 San Felipe Suite 1500 Houston Tx 77056 USA Powell Industries, Inc. service Division 8550 Mosley Rd Houston TX 77075-1180 USA INSURER B: INSURER C: INSURER E: INSURERS) AFFORDING COVERAGENAIC It THIS IS TO CERTIFY THAT THE POLICIESOFINSURANCE 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. Limits shown are as requested Lm TYPE OF INSURANCE INSD WVD POLICY NUMBER _- DD Exp MMID V _ .. A X COMMERCIAL GENERAL LIABILITY 5 .UIIU'IZULUEACH OCCURRENCE $1,000,000 CLAIMS -MADE ❑x OCCUR SIR applies per policy terns & conditions PREMISES Ea occurrence $50,000 MED EXP (Any one person) $5, 000 PERSONALS ADV-INJURY $1,000-,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000, 000 POLICY ❑X JEO- LOC PRODUCTS-COMP/OPAGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY Y 1000635719191 07/01/201907/01/20,20 COMBINED SINGLE LIMIT accident) $2,000,000 BODILY INJURY ( Per person) X AI,NYAUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY .AUTOS ONLY P I PROPERTY DAMAGE Per accident OCCUR EACH OCCURRENCE AGGREGATE 7BRELLI"Ll EXCESS LIARH CLAIMS -MADE DED RETENTION A WORKERS COMPENSATION AND EMPLOYERS' LUIBILNTY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 1000003738 67 01 2019 07 O1/2020 X PER STATUTE -- O7H- E E.L. EACH ACCIDENT $1,000,006 OFFICERNEMBER EXCWDED9 N (Mandatory in NN) N/A E.L. DISEASE -EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional city of Fort Collins is included as Additional Insu�'ed Remarks Schedule, may be attached If more space Is required) in accordance with the policy provisions of the General Liability and Automobile Liability policies. CERTIFICATE HOLDER CANCELLATION City Of Fort Collins PO Box 580 Fart Collins Tx 80522 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUn10RRED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD