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HomeMy WebLinkAboutMCBRIDE LIGHTING INC - INSURANCE CERTIFICATE (2)MCBRI-2 OP ID: SS CERTIFICATE OF LIABILITY INSURANCE 7(MM/DDNYYY) /24/2016 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 endorsements . CONTAPRODUCER Phone: 720-962-0930 NAME: Shaleen Martin Six & Geving Insurance Inc #4 Fax: 720-962-0942 PHONE 303-653-0023 FAx Denver Branch (rvc. No. Ell: (ac, No): 720-962-0942 225 Union Blvd. #575 E-MAIL RE Lakewood, CO 80228 SS; Smartin@six-geving.COm John Shockley INSURERS AFFORDING COVERAGE NAIC # INSURER A: United Fire & Casualty Company 13021 INSURED McBride Lighting Inc INSURERB: 16026 W. 5th Ave INSURER C : Golden, CO 80401 INSURER D INSURER E : INSURER F CAVFRAnFR CERTIFICATE NIIIMRFR- RFVISIC)N NIIMRFR- 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 TYPE OF INSURANCE ADDL SUB R POLICY EFF POLICY EXP LIMBS LTR POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FXI OCCUR 60474508 04/01/2016 04/01/2017 EACH OCCURRENCE $ 1,000,000. AMAGE TOENcur PREMISES a occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY XF—yPRO JECTLOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS 60474508 04/01/2016 04/01/2017 COMBINED SINGLE LIMIT Ea accident 1 000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 60474508 04/01/2016 04/01/2017 EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,00 DIED I X I RETENTION $ 10000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- I JOTH- O Y LIMITS E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E-L. DISEASE - POLICY LIMIT $ A Leased/RentedEquip 60474508 04/01/2016 04/01/2017 Rented Eq 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) l.tK 111-II,A I t MULUtK GANI.tLLA I IUN CTYFO-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE JXC��� 0i ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD