HomeMy WebLinkAboutSIMPSON ELECTRIC INC - INSURANCE CERTIFICATE (15)ACOR TOO
u_ CERTIFICATE OF LIABILITY INSURANCE
DATE nAedrYYY
u1ae
THIS CERTIFICATEISISSUED 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: N the ceAiRcale holder is an ADDITIONAL INSURED, dre policy(ies) rr'ud rove ADDITIONAL INSURED provisions or be endorsed. It
SUBROGATION IS WAIVED, SubJSCt to the terms. and conditions Of " POlicy, certain policies may require an endorsement A statement on this
certi/leate does nol confer rlqMtothe .certlflcste_holder .In lieu of such em Drsem s
PRODUCER
CONTACT CLIENT CENTER
nl�cN� E>M : 88&333-4949 wrc ne : 507-046d664
FEDERATED MUTUAL INSURANCE COMPANY
_...
HOME OFFICE:. P.O. BDX 328
a DNeS& CLIENTCONTACTCENTER FEDINS.COM
OWATONNA, MN 55060
INSURERUS) AFFORDING COVERAGE
NAIL N
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 189-714-9
INSURER B: FEDERATED SERVICE INSURANCE COMPANY
28304
INSURER C.
SIMPSON ELECTRIC, INC.
220 12TH ST SW
LOVELAND, CO 80537-Ml
INSURER D:
ER
INSURE:
INSURER F:
M%MnAncC B DTICICSTF MIIMIWR• 11 HCYISIVn MUMOCHI U
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
CERTIFICATEMAYBE 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.
INS R
TYPE OF INSURANCE
DL
SUER
POLICY NUMBER
POLICY EFF
M I YYY
POLICY EKP
UMITS-
A
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
BUSINESS OWNER'S LIABILITY
Y
N
6124979
04/01/2020
04/01/2021
EACH OCCURRENCE
$1,000,000
DAMAGE RENTED
PN
$100,000
X
MED E%P (Any am Part aw)
PERSONAL& ADV INJURY
$1,000,000
AGGREO TE LIMIT APPLIES PER:
LICY � ECT ❑LOD
TOTHER:
GENERAL AGGREGATE'
$2,000.000
PRODUCTSCOMPIOP,AGO
$2,000,000
Li
AUTOMOBILE
X
LIABILITY
ANY AUTO
OWNED AUTOS ONLY SCHEDULED
AUTOS
HIRED AUTOS ONLY MON-OWNED Aulas ONLY
N
N
6124980
04/01/2020
04/01/2021
dome mg odsiNGLE UNIT -
- - -- — $1,000,000
BODILY INJURY (Par Penan)
GODLY INJURY IPsf dmdHltl
_
TY.PROPERDAMAGE
A
X
UMBRELLA LIAR
EI0CEF= LIAB
X
OCCUR
CLAIMS -MADE
N
N
6124991
04/01l2020
04/01/2021
EACH OCCURRENCE
$1,000,000
AGGREGATE
$1,000,000
LIED RETENTION _
WORKERS COMPENSATION
Am/ EMPLOYERS' LIABILITY J
ANY PROPRIETORMARTNERIE%ECUTIVE
OFFICERIMEMBER EX LUDED?
(MJSWalary In FIN)
N yes, desoibe Under
DESCRIPTION OF OPERATIONS Wow
N I A
OTH
PER STATUTE I I ER
E.L. EACH ACCIDENT
E.L. DISEASEEA EMPLOYEE
El DISEASE • POLICY LIMIT
DESCRIPTION OF OPERATIONS I U)CATIONS 1 VEHICLES (ACORD 101. Addibe l ReTMO Saleerle, Tay be aDW W d it mae ranee is rupdred)
THE CERTIFICATE HOLDER IS AN AIXIITIONAL. INSURED SUBJECT TO THE CONDITIDNS OF THE'A1roITIDNAL INSURED BY CONTRACT
ENDORSEMENT FOR BUSINESSOMNERS LIABILITY.
r w+resu
189-714-9 •`.••_W`
110
SHOULD ANY OF THE ABOVE: DESCRIBED POLICIES BE CANCELLED BEFORE
CITY OF FORT COLLINS
THE EXPIRATION DATE THEREOF, NOTICE
WILL BE DELIVERED IN
PO BOX 580
ACCORDANCE WITH THE. POLICY PROVISIONS.
FORT COLLINS, CO 80522-0580
AUTHORIZED REPRESENTATIVES • , , /
1
� 15atl-ZU70 AW1t1/ W HYVIW I I VI1. MII fi JfR3 f WmYW.
AOORD 25 (201WW) The ACORD name and logo are registered marks of AC.ORD