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HomeMy WebLinkAboutT & T ELECTRIC CO INC - INSURANCE CERTIFICATE (3)ACORU° PRODUCER Western Group Inc. -Pueblo 511 W 10th St Ste A P.O. Box 1958 Pueblo, CO 81002 George C. Shineovich T&TEL-1 OP ID: SV CERTIFICATE OF LIABILITY INSURANCE 71-1 (MM/DD/YYYY) /03/2015 Phone: 719-543-3604 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURED T & T Electric Co Inc Tim & Katherine Miller 1824 Aspen Circle Pueblo, CO 81006-1489 CnVFRAGFS INSURERS AFFORDING COVERAGE NAIC # INSURER A. COLORADO CASUALTY INS.CO. 41785 INSURER B: INSURER D: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD' POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM/DD/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE U OCCUR CBP8522992 11/08/2015 11/08/2016 EACH OCCURRENCE $ 1,000,00 DAMAGE PREMISES (Ea oNcurence $ 100,00 MED EXP (Any one person) $ 15,00 PERSONAL & ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO-JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,00 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS IBA8529091 11/08/2015 11/08/2016 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (PER PERSON) $ BODILY INJURY (PER ACCIDENT) $ PROPERTY DAMAGE (PER ACCIDENT) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS / UMBRELLA LIABILITY X OCCUR CLAIMSMADE DEDUCTIBLE X RETENTION $ 10,000 CU8535400 11/08/2015 11/08/2016 EACH OCCURRENCE $ 6,000,00 AGGREGATE $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PAR-(NER/EXECUTIVE OFFICER/MEMBER EXCLUDED? u (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below WC STATU- OTH- RY LIMITS E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT 1 $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ELECTRICAL WORK WITHIN BUILDINGS fax 970-224-6134 CITYFTC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN CITY OF FT. COLLINS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 330 S. COLLEGE AVE. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. BOX 580 REPRESENTATIVES. ` FT COLLINS, CO 80522-0580 AUTHQJRIZE RF E�T!YEGeorg C. S -oyiGo ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACOR CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 2/22/2015 PRODUCER Pinnacol Assurance 7501 E Lowry Blvd Denver, ow 80230 7006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A. PinnaC01 Assurance 41190 T & T Electric Company Inc 1824 Aspen Circle Pueblo, CO 81006 INSURER B: _ INSURER C: INSURER D: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDNG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMMENT 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 ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YYYY DATE(MMIDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PREMISES MED EXP(Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIERS PER: GENERAL AGGREGATE PRODUCTS - COMPIOP AGG POLICY PROJECT LOC AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT ANY AUTO Ea Accident BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per parson) BODILY INJURY HIRED AUTOS NON -OWNED AUTOS (Per accident PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY -EA ACCIDENT OTHER THAN EA ACC ANY AUTO AUTO ONLY: AG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND WC STATU- 11 OTHER A EMPLOYER'S LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4007696 01 /01 /2016 01 /01 /201 % TORY LIMITS El EACH ACCIDENT $1,000,000 El DISEASE - EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? If yes, pleasedwribe under SPECIAL PROVISIONS below El DISEASE- POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION 1663666 City of Fort Collins P.O Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO NOTIFY 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO NOTIFY SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. _ AUTHORIZED REPRESENTATIVE Joshua Gonda ACORD 25(2001/08) underwriter ACORD CORPORATION 1988 CERTIFICATE HOLDER COPY City of Fort Collins P.O Box 580 Fort Collins, CO 80522 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.