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HomeMy WebLinkAbout114215 MERIT ELECTRIC INC - INSURANCE CERTIFICATE (11)ACORbr k._� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/17/2015 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(ies) must 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 CONTACT Jennifer Winter CISR NAME: Flood and Peterson FAX PHONE (970) 506-3206 (A/C (970)506-6846 (A/C. No IL JWinter@flood eterson.com E-ADMADRE.P PO BOX 578 INSURERS AFFORDING COVERAGE NAIC # INSURER A:Charter Oak Fire Insurance Co 25615 Greeley CO 80632 INSURED INSURERB:Travelers Property Casualty Co 25674 INSURERC:Pinnacol Assurance 41190 Merit Electric, Inc. INSURER D: 2643 Midpoint Drive, Suite F INSURER E INSURER F Fort Collins CO 80525 COVERAGES CERTIFICATE NUMBER:CL1561703724 REVISION NUMBER: 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. IN TR TYPE OF INSURANCE I OL UBR POLICY NUMBER Y EFF MM/DD/YYYY POLICY EXP MM DDYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTE PRE M SES (Ea occur ence) $ 300,000 A I CLAIMS -MADE Fx_1 OCCUR 4TC03532R691COF15 /1/2015 /1/2016 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 X PD Ded: 5 , 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 4T8103532R691COF15 /1/2015 /1/2016 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS Ex X $ Drive Other Car X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 B EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 10,000 $ 4TSMCUP3532RG91TIL15 /1/2015 /1/2016 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPR OFFICER/MEIMBEOR/PARTNER/EXEXCLUDED? ECUTIVE (Mandatory in NH) N /A 4070414 /1/2015 7/1/2016 X WC STATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522-0580 J Winter, CISR/JWINTE ACORD 25 (2010/05) INS095 rgninnst ni ©1988-2010 ACORD CORPORATION. All rights reserved. Tlia Ar ewn nmma —A Inn^ mrn rnnic4crnrl m=rlrc of Ar npn