No preview available
HomeMy WebLinkAbout114215 MERIT ELECTRIC INC - INSURANCE CERTIFICATE (16)AC" o CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 6/22/2017 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 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 Flood and Peterson PO Box 578 cONTAcr Jennifer Winter, CISR NAME: PHONE t (970) 506-3206 FAX No: (970)506-6846 ADDRESS:JWinter@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC # INSURER A .Westfield Insurance Company 24112 Greeley CO 80632 INSURED INSURER B :Pinnacol Assurance 41190 INSURERC: Merit Electric, Inc. INSURERD: 2643 Midpoint Drive, Suite F INSURER E : INSURERF: Fort Collins CO 80525 COVERAUhb %lr-r%1Irwr+1 --- — - 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. INAD SURANCE NERAL LIABILITY E C OCCUR BR POLICY NUMBER CMt44691001 POLICY EFF MM/DD/YYYY 7/1/2017 POLICY EXP MM/DD/YYYY 7/1/2018 LIMITS EACH OCCURRENCE $ 1,000,000 DAMAGE T RENTED PREMISES Eaocwrcence 500,000 $0 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRO- D PRODUCTS -COMP/OP AGG $ 2,000,000 POLICY JECT LOC $ OTHER'. AUTOMOBILE LIABILITY Ee acccdenntSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ A %{ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS t844691001 7/1/2017 7/1/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X Drive Other Car j[ UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5 000 000 AGGREGATE $ 5 000 000 A EXCESS LIAB CLAIMS -MADE C M4691001 7/1/2017 7/1/2018 X PER OTH- STATUTE I I ER $ DED X RETENTIONS 0 WORKERS COMPENSATION E.L. EACH ACCIDENT $ 1,000,000 B AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4070414 7/1/2017 7/1/2018 E.L. DISEASE - EA EMPLOYE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIt-IUA I E HL)LUCK City of Fort Collins PO Box 580 Fort Collins, CO 80522-0580 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 J Winter, CISR/JWINTE ACORD 25 (2014101) INS025 r9nt4ntl The ACORD name and logo are registered marks of ACORD i+/�n nr1�A TIr%Kl All . kfL --arl ........-