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HomeMy WebLinkAbout125947 PTACEK ENTERPRISES INC DBA BATTERIES PLUS - INSURANCE CERTIFICATE (5)ACORG70 �...-. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 8/4/2015 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 Molyneaux Insurance Inc. 100 Kirkwood Blvd. PO Box 939 CONTACT NAME: Kristen Saneckl P"°NE 563-324-1011 FAX 563-324-7909 EMAIL kristen mol neaux.com @ Y INSURERS AFFORDING COVERAGE NAIC # Davenport IA 52803 INSURER A: Travelers DB Post Property Casual 36161 INSURED PTACENT-01 INSURER B : _ INSURERC: Ptacek Enterprises, Inc. dba Batteries Plus 1107 W. Drake, Unit E-3 INSURERD: Fort Collins CO 80526 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 68044672 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. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y 6802289W988 8/8/2015 8/8/2016 EACH OCCURRENCE $2,000,000 DAMAGES( RENTED PREMISES Ea occurrence) $300,000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT OTHER: GENERAL AGGREGATE $4,000,000 X PRODUCTS - COMP/OP AGG $4,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED X AUTOS NON -OWNED HIRED AUTOS X AUTOS BA615D3648 8/8/2015 8/8/2016 Ea accident I $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS MADE CUP2061 W503 8/8/2015 8/8/2016 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DIED X I RETENTION$5,000 $ A WORKERS COMPENSATION EMPLOYERS' LIABILITY Y / N iANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? ((Mandatory in NH) If yes, dcs b3 under DESCRIPTION OF OPERATIONS below N/A — - IHUB629D6856 8/8/2015 8/8/2016 X PEA STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.I. DISEASE -POLICY LIMIT i $1,000,000 I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Fort Collins Utilities 700 Wood St Fort Collins CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD