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Home My WebLink About519412 WARD ALTERNATIVE ENERGY LLC - INSURANCE CERTIFICATE (2)WARDALT-01 TRAMOS ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 10/13/2015 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: Dillingham Insurance PHONE (580) 233-2000 aC No): (580) 242-6703 A/C No Ext : P.O. Box 1669 Enid, OK 73702 - E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Mid -Continent Casualty Company 23418 INSURED INSURERB:Artisan and Truckers Casualty Company 10194 Ward Alternative Energy, LLC INSURERC: INSURER D : 5660 E. 58th Avenue Commerce City, CO 80022 INSURERE: 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 DL UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE u OCCUR X 04GL939583 10/12/2015 10/12/2016 DAMA T RENTED PREMISES Ea occurrence $ 100,00 ME EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $ 1,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PE LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO X 01898979-3 10/12/2015 10/12/2016 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 4,000,00 AGGREGATE $ 4,000,00 A X EXCESS LIAB CLAIMS -MADE 04XS193014 10/12/2015 10/12/2016 DED I X RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is additional insured as respects to the auto liability and general liability policy. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Attn: Purchasing P.O. Box 580 Fort Collins, CO 80522 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD DILLINGHAM INSURANCE PRi?8RFll/UE® P 0 BOX 1669 ENID, OK 73702 Policy number: 01898979-3 Underwritten by: Artisan and Truckers Casualty Co Insured: WARD ALTERNATIVE ENERGY, CITY OF FORT COLLIN October 15, 2015 PO BOX 5 FORT COLLINS, CO 80522 Policy Period: Oct 12, 2015 - Oct 12, 2016 Mailing Address Artisan and Truckers Casualty Co PO Box 94739 Additional insured endorsement Cleveland, OH 44101 1-800-444-4487 For customer service, 24 hours a day, Name of Person or Organization 7 days a week CITY OF FORT COLLIN PO BOX 580 FORT COLLINS, CO 80522 The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page. Limit of Liability Bodily Injury Not applicable Property Damage Not applicable Combined Liability $1,000,000 each accident All other terms, limits and provisions of this policy remain unchanged. This endorsement applies to Policy Number: 01898979-3 Issued to (Name of Insured): WARD ALTERNATIVE ENERGY, LLC Effective date of endorsement: 10/12/2015 Policy expiration date: 10/12/2016 Form 1198 (01iO4)