HomeMy WebLinkAboutCENTURY ELECTRIC COMPANY LLC - INSURANCE CERTIFICATEAoCC)R 6'
CERTIFICATE OF LIABILITY INSURANCE
DATE D/YVYY)
07/24/7/24/2015
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 endorsements .
PRODUCER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328(AC,No
CONTCT
NAME:ACLIENT CONTACT CENTER
PHONE FAX
A/ Ext : 888-333-4949 c No): 507-446-4664
E-MAIL
ADDRESS: CLIENTCONTACTCENTER FEDINS.COM
OWATONNA, MN 55060
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 270-468-2
INSURER B:
CENTURY ELECTRIC COMPANY LLC
7925 E HARVARD AVE STE E
INSURER C:
INSURER D:
DENVER, CO 80231
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 6 REVISION NUMBER: 0
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.
INSR
LTR
TYPE OF INSURANCE
ADDL
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMIDDIYYYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$1,000,000
COMMERCIAL GENERAL LIABILITY
DAMMISES AGE ( RENTEDE.
occurrence)
$100,000
CLAIMS -MADE X OCCUR
MED EXP (Any one person)
PERSONAL & ADV INJURY
$1,000,000
A
X BUSINESS OWNER'S LIABILITY
Y
Y
9231888
09/01/2015
09/01/2016
GENERAL AGGREGATE
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$2,000,000
X POLICY PRO-
JECT F LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$1,000,000
X
ANY AUTO
BODILY INJURY (Per person)
A
ALL OWNED SCHEDULED
AUTOS AUTOS
Y
Y
9231889
09/01/2015
09/01/2016
BODILY INJURY (Per accident)
HIRED AUTOS NON -OWNED AUTOS
PROPERTY DAMAGE
Per acciden
X
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$5,000,000
A
EXCESS LIAB
CLAIMS -MADE
N
N
9231890
09/01/2015
09/01/2016
AGGREGATE
$5,000,000
DED I I RETENTION
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
X
WC STATU-
TORY LIMITS
OTH-
ER
E.L. EACH ACCIDENT
$500,000
ANY PROPRIETORIPARTNERIEXECUTIVE
A
OFFICERIMEMBER EXCLUDED? D
NIA
N
9103745
09/01/2015
09/01/2016
E.L. DISEASE - EA EMPLOYEE
$500,000
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
E.L DISEASE -POLICY LIMIT
$500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
SEE ATTACHED PAGE
CERTIFICATE HOLDER CANCELLATION
270-468-2
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522-0580
60
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: 270-468-2
�., LOC #:
ACORL®
ADDITIONAL REMARKS SCHEDULE Page 1 of
AGENCY
NAMEDINSURED
FEDERATED MUTUAL INSURANCE COMPANY
CENTURY ELECTRIC COMPANY LLC
7925 E HARVARD AVE STE E
DENVER, CO 80231
POLICY NUMBER
SEE CERTIFICATE # 6.0
CARRIER
NAIC CODE
SEE CERTIFICATE # 6.0
EFFECTIVE DATE: SEE CERTIFICATE # 6.0
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATEHOLDER IS AN ADDITIONAL INSURED SUBJECT TO THE
CONDITIONS OF THE ADDITIONAL INSURED BY CONTRACT ENDORSEMENT
FOR BUSINESSOWNERS LIABILITY AND BUSINESS AUTO LIABILITY.
BUSINESSOWNERS LIABILITY AND BUSINESS AUTO LIABILITY CONTAIN
WAIVERS OF SUBROGATION IN FAVOR OF THE CERTIFICATEHOLDER
SUBJECT TO THE CONDITIONS OF THE BLANKET WAIVER OF TRANSFER
OF RIGHTS OF RECOVERY ENDORSEMENT.
ACORD 101 (2008/01) O 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD