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HomeMy WebLinkAboutDEPAUL ELECTRIC - INSURANCE CERTIFICATEA CERTIFICATE OF LIABILITY INSURANCE f °ATE'01/27/1 YYY'� /27/16 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 NTACT Debbie Klisch CNA Southern Colorado Insurance Center PHONE (719) 329 4441 ac No): (719) 457-5923 4390 N Academy Blvd A-MAILDDRESS, debbie®scicteam.com INSURE S AFFORDING COVERAGE NAIC # Colorado Springs, CO 80918 INSURER A: Liberty Mutual insurance Phone (719) 329-4441 Fax (719) 457-5923 INSURED INSURER B : Pinnacol Assurance INSURERC: DePaul Electric INSURER D 7889 Kettle Dawn INSURER E : Colorado Springs, CO 80922 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. ILTRR OF INSURANCE ADDLTYPE INS& UBR POLICY NUMBER MMICD� POLICY M/I Dry LIMITS A GENERAL LIABILITY © COMMERCIAL GENERAL LIABILITY ❑ ❑ CLAIMS -MADE d❑ OCCUR ❑ BKS (14) 556254490 EACH OCCURRENCE $ 1,000,000.00 DA AGE To PREM SES Ea occurrence) ence $ 100,000.00 MED EXP (Any one person) $ 5,000.00 PERSONAL BADV INJURY $ 1,000,000.00 ❑ GENERAL AGGREGATE $ ZOIX1,000.00 _ GEN'L AGGREGATE LIMIT APPLIES PER: ❑ POLICY ❑ P� T © LOC PRODUCTS - COMP/OP AGG $ 2,000,000.00 AUTOMOBILE LIABILITY ❑ ANY AUTO ❑ALL OWNED SCHEDULED AUTOS ❑ AUTOS ❑HIRED AUTOS NON -OWNED ❑ AUTOS ❑ ❑ COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ ❑ UMBRELLA LIAB ❑ OCCUR ❑ EXCESS LIAB ❑ CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DIED ❑ RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTNE OFFICER/MEMBEREXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4184754 07/01/2015 07/01/2016 WC 3LTLATU- ❑ OTH- E.L. EACH ACCIDENT $ 100,000.00 E.L. DISEASE - EA EMPLOYE $ 100,000.00 E.L. DISEASE -POLICY LIMIT $ 500,000.00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER City of Fort Collins PO Box 580 Fort Collins, CO 80522 ACORD 25 (2010105) QF CANCELLATION 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 Debbie Klisch ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD