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Home My WebLink About399052 ENERGYLOGIC INC - INSURANCE CERTIFICATE (5)ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDNYYY) F09/15/2015 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 NAME: Lockton Affinity, LLC Lockton Affinity, LLC PHONE A'C No Ext:800-806-0263 FAIL No: 913-652-7599 E-MAIL P.O. Box 879610 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC9 Kansas City, MO 64187-9610 INSURER A: Hartford Casualty Insurance Company 29424 INSURED INSURER B : EnergyLogic, Inc. INSURER C PO Box N 525 E Cty Rd (Hwy 56) INSURER D INSURERE: Berthoud, CO 80513 INSURER F : COVERAGES CERTIFICATE NUMBER: 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 ADDLISUBRI POLICY NUMBER MMIDD/YYY MMFF IDD/YICY YY LIMITS A X COMMERCIAL GENERAL LIABILITY x 37SBAAR6056-09 10/20/2015 10/20/2016 EACH OCCURRENCE s2,000,000 PREMISES Ea occurrence $ 300 , 000 CLAIMS -MADE a OCCUR MED EXP (Any one person) $ 10 , 000 PERSONAL & ADV INJURY s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4 , 000 , 000 POLICY JET Xa LOC PRODUCTS - COMPIOP AGG S4,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) S HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident S 5 UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE S AGGREGATE 5 EXCESS LIAB DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER E.L. EACH ACCIOFNT S ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYEE S (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate Holder is listed as Additional Insured to the General Liability as respects to work performed by Named Insured per Hartford Policy Form SS 00 08 04 05. CERTIFICATE HOLDER CANCELLATION City of Fort Collins 215 N Mason Street PO Box 580 Fort Collins, CO 80522 ACORD 25 (2014/01) 17337345 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 14 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD 990567