HomeMy WebLinkAboutDURO ELECTRIC - INSURANCE CERTIFICATE (2)A` ® DATE (YYYY)
CERTIFICATE OF LIABILITY INSURANCE o2
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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).
rEpolis,
CONTACT
E.
USA Inc. PHONPHONEuth 7th Street, Suite 1400 Extl� MN 55402-2400 E-MAIL
E-MAIL !AnnDrQQ.
INSURER(S) AFFORDING COVERAGE NAIC #
J43750-DURO-GAWX-16-17 INSURER A: Liberty Mutual Fire Ins Co 23035
INSURED INSURER B : Associated Electric & Gas Ins Services Ltd 3190004
Duro Electric Company — — -- _--- -_
2271 VVest Yale Avenue INSURER C : Liberty Mutual Insurance Company 23043
Englewood, CO 80110 INSURER D :
INSURER E :
CnVFRAP,FS rFRTIGIr_ATF NI IMRFR- CHI-006534592-03 RF1flS!r)N NIIMPFR•I
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 ADDL R sUBPOLICY EFF I POLICY EXP LIMITS
LTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
A
X
COMMERCIAL GENERAL LIABILITY
TB2-641-005097-046
01i01/2016
LACH OCCURRENCE
$ 2,000,000
CLAIMS -MADE FXI OCCUR
�11101/2017
DAMAGE TO RENTED
PREMISES Ea occurrence)
$ 500.000
X
MED EXP (Any one person)
$ 10.000
PER PROJECT AGGREGATE
PERSONAL & ADV INJURY
$ 2,000.000
GEN'L AGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$ 4,000,000
POLICY PRO JECT ❑ LOC
-
PCOMP/OP AGG_
$ 4,000.000
_RODUCTS ___
$
OTHER
A
AUTOMOBILE LIABILITY
Al2-G41-005097-056
01/01!2016
i01/0112017
COMBINED SINGLE LIMIT
Ea accident`
$ 2,000,000
BODILY INJURY (Per person)
$
ANY AUTO
$
ALL OWNED SCHEDULED
AUTOS AUTOS
jx�
BODILY INJURY (Peraccident)
PROPERTYDAM
Per accident
$AGEHIRED
NON -OWNED
AUTOS AUTOS
B
UMBRELLA L!AB
OCCUR
XL5063405P
01/01/2016
01/01,'2017
EACH OCCURRENCE
$ 5,000,000
X
HCLAIMS-MADE
AGGREGATE
$ 5,000,000
EXCESS LIAR
DIEDRETENTION $
$
C
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y�
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
N / A
WA7-64D-005097-016(AOS)
°INCLUDES "STOP GAP
01/01/2016
01/01/2017
X IPER • STATUTE ORH
-
L.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
-----
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
1,000,000DESCRIPTION
$
If yes, describe under
OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached if more space is required)
Excess liability applies to general liability, products and completed operations, automobile liability, and employers liability.
CFRTlF:lrATF 14r11 r1FR (:QM[:FI I ATION
City of Fort Collins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
281 N. College Ave.
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERS& IN
Fort Collins, CO 80522-0580
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
of Marsh USA Inc.
Manashi Mukherjee[�uati
U 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
AGENCY CUSTOMER ID: J43_750
LOC #: Minneapolis
,a�oRo ADDITIONAL REMARKS SCHEDULE Page 2 of 2
AGENCY
Marsh USA Inc.
NAMED INSURED
Duro Electric Company
2271 West Yale Avenue
Englewood, CO 80110
POLICY NUMBER
CARRIER
NAIC CODE
EFFECTIVE DATE:
ADDITIONAL REMARKS
THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM,
FORM NUMBER: 25 FORM 1 ITLE: Certificate of Liability Insurance
Coverage for Duro Electric Company effective 2/1/2016.
ACORD 101 (2008/01) Oc 2008 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD