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HomeMy WebLinkAboutDIVERSIFIED ELECTRIC & CONTROL LLC - INSURANCE CERTIFICATE (2)DIVER01 OP ID: Cl ACv�Q'- CERTIFICATE OF LIABILITY INSURANCE ATE (MMlDD/YYYY) TE(MMI DNY r016 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 Bradley Insurance Group 3401 W. 38th Avenue CONTACT Lori Boger PHONE FAx A/C No Ext : 303-480-5005 A/c No): 303-458-5857 ADDRIESS: lori@bradleyinsurancegroup.com Denver, CO 80211 Timothy D. Westbrook INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Ohio Security Insurance Co. INSURED Diversified Electric & Control INSURER 13: AmTrust North America LLC 4191 Inca Street INSURER C : INSURER D: Denver, CO 80211 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. ILTR TYPE OF INSURANCE INSD WV POLICY NUMBER MM/DD/YEYYY MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR BKS57176801 04/13/2016 04/13/2017 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ 300,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: POLICY � JERCOT- LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS -COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BAS57176801 04/13/2016 04/13/2017 COMBINED SINGLE LIMIT Ea accident $ 1,000,00 X BODILY INJURY (Per person) $ BODILY INJURY Per accident ( ) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE US057176801 04/13/2016 04/13/2017 EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 DED I X I RETENTION $ 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY IN ANY PROPRIETOR/PARTNER/EXECUTIVE Yj—v� OFFICERIMEMBER EXCLUDED L T (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A MWC1013352 04/13/2016 04/01/2017 PE TH- X STATUTE ER E.L. EACH ACCIDENT $ 500,00 E.L. DISEASE - EA EMPLOYEEI $ 500,00 E.L. DISEASE - POLICY LIMIT 1 $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins P.O. Box 580 Fort Collins, CO 80522-0580 t,ANL:tLL.A 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 Timothy D. Westbrook © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD