HomeMy WebLinkAbout399052 ENERGY LOGIC INC - INSURANCE CERTIFICATE (2),�coRo® CERTIFICATE OF LIABILITY INSURANCE DAT03/022016)
�i 03/02l2016
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:
Marsh Sponsored Programs PHONE 1-877.320.9393 FAx 515-365-0895
a division of Marsh USA, Inc. E-MAIL Driskmanagement@marshpm.com ac NoVendor ID: 31459
POBox 14404______...___........._._....._.--.------...__..
Des Moines, IA 50306.9686 INSURERS AFFORDING COVERAGE NAIC #
INSURER A: Old Republic Insurance Company_ 24147
INSURED
INSURER B
Energy Logic, Inc. INSURER C_
309 Mountain Ave INSURER D:
Berthoud, CO 80513 _INSURER E
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
ADDL
SUER
POLICY NUMBER
POLICY EFF
MM/DD/YYY
POLICY EXP
W MM/DD/YY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
TO RENTED
DAMAGCLAIMS
MADE D OCCUR
PR M SEES ma. e
�Ea cec.ma..)
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$
POLICY u PRO D LOC
J ECT
PRODUCTS - COMP/OP AGG
$
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
A
- - ALL OWNED -.. SCHEDULED
AUTOS X AUTOS
X
X
L388052.16
04/01l2016
04/01l2017
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
_LPa accidentL_
$
X HIRED AUTOS X NON -OWNED
AUTOS
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
PER OTH-
STATUTE I ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
OFFICERlMEMBER EXCLUDED? ❑
N / A
-
E.L. DISEASE - EA EMPLOYEE
--""— --"—"--""-"
$
(Mandatory in NH)
Ityes, describe under
_
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
i
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) GPBR: 1 ML2
Policy provides protection for any & all operations/jobs performed by the named insured where required by written contract. Certificate holder is an Additional Insured where required by written contract.
Waiver of Subrogation included where required by written contract. Insurance is primary and non-contributory.
Additional Insured: City of Fort Collins, Fort Collins Utilites
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Fort Collins Utilities THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
215 N. Mason Street, 2nd Floor
P.O. Box 580 AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80522
I
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ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD