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HomeMy WebLinkAboutCORE ELECTRIC - INSURANCE CERTIFICATE (2)AC"Ro® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) F9/22/2015 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 Keller -Lowry Insurance 1777 S Harrison St #700 Denver CO 80210 CONTACT Heather Wilt CIC NAME: A/CNNo Ext: (303) 756-9909 A/� No: (303)756-8818 E-MAIL ADDRESS: Heather@kellerlowry' com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Cincinnati Insurance 10677 INSURED Core Electric, Inc. 197 S 104th St., Suite A Louisville CO 80027 INSURER B :Pinnacol Assurance 41190 INSURERC: INSURERD: INSURER E : INSURERF: COVFRAGES CERTIFICATE NUM6ER15-16 GL BA WC UMB REVISION Nt1MBERr 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 UBR POLICY NUMBER MM DD/YYYPOLICY F PO LICY EXP DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR EPP0279133 10/1/2015 10/1/2016 EACH OCCURRENCE $ 1,000,000 RENTED P EM SESODAMAGE TEa occurrence $ 500,000 MED EXP (Any one person) $ 10 , 000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC JECT OTHER. GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 Employee Benefits -Claims $ 1,000,000 A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS AUTOS EPP0279133 10/1/2015 10/1/2016 COMEaaccident BINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ Underinsured motorist el $ Included A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIM! MADE EPP0279133 10/1/2015 10/1/2016 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DED (RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? in N4126423 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 10/1/2015 10/1/2016 PER X OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYE $ 1 000 000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins P.O. Box 580 Fort Collins, CO 80525 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 T Sibelius CIC CRM/HM ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401)