HomeMy WebLinkAboutADVANCED ELECTRICAL SERVICES - INSURANCE CERTIFICATE (7)A46- r CERTIFICATE OF LIABILITY INSURANCE
FDATE 07/20/ 017
O7/20/2017
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 have ADDITIONAL INSURED provisions or 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 .
PRODUCER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328
CONTACT
NAME: CLIENT CONTACT CENTER
A CNNo Ext : 888-333-4949 A/C No): 507-446-4664
ADDRESS: CLIENTCONTACTCENTER FEDINS.COM
OWATONNA, MN 55060
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 256-137-1
INSURER B:
ADVANCED ELECTRICAL SERVICES
INSURER C:
345 W 12TH ST
INSURER D:
LOVELAND, CO 80537-4645
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 5 REVISION NUMBER: 0
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
INSR
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE Fx OCCUR
BUSINESS OWNER'S LIABILITY
N
N
9160853
09/03/2017
09/03/2018
EACH OCCURRENCE
$1,000,000
DA PREMISES Ea oc AGE TocRENTuronce
$100,000
X
MED EXP (Any one person)
GEN'L
NPOLICY
PERSONAL & ADV INJURY
$1,000,000
AGGREGATE LIMIT APPLIES PER:
❑ JEST ❑ LOC
OTHER:
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP/OP AGG
$2,000,000
AUTOMOBILE
LIABILITY
ANY AUTO
OWNED AUTOS ONLY SCHEDULED AUTOS
HIRED AUTOS ONLY NON -OWNED
AUTOS ONLY
COMBINED SINGLE LIMIT
Ea acciden
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
Per accident)
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
AGGREGATE
DED I RETENTION
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 I A
PER STATUTE
OTH-
ER
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPLOYEE
E.L DISEASE -POLICY LIMIT
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
256-137-1
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522-0580
50
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
nc 19RR_9n15 ACORr) CnPPnPATION All rinhfc reserved
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD