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HomeMy WebLinkAboutMOONLIGHT ELECTRIC INC - INSURANCE CERTIFICATE (5)1 ® F�DA�TE(MMIDDIYYYY) A� CERTIFICATE OF LIABILITY INSURANCE 06/21 /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 tha 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 CONTACT NAME: Richard Marchesini(0717310) PHONE , 303-969-9287 Fv N,: 303-969-8007 3900 S Wadsworth Blvd Ste 365 ennRlvcs• rmnrrthAcini(n>farmarcanant mm Lakewood CO 80235-2220 INSURER A: Truck Insurance Exchange 21709 INSURED MOONLIGHT ELECTRIC INC 26731 WELD COUNTY ROAD 18 KEENESBURG CO 80643 INSURER B : Farmers Insurance Exchange 21652 INSURER c Mid Century Insurance Company 21687 _: INSURER D : INSURER E : INSURER F : C()VFRAr:FR CFRTIFICATF NIIMRFR• RFVIfiI(AN 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 ADDLISUBR POLICY EFF �POLICY EXP -- LTR TYPE OF INSURANCE lINSR WVD POLICY NUMBER MMIDDIYYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 CLAIMS -MADE X OCCUR I MED EXP (Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 C Y N 604833002 06/16/2017 06/16/2018 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ X POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ ANY AUTO C ALL OWNED SCHEDULED X AUTOS AUTOS 604833002 06/16/2017 06/16/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS I AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB HCLAIMS-MADE 604833020 06/16/2017 06/16/2018 DED I X I RETENTION $ 10,000 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE WC STATULIMLT- OTH- RY ER E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under DESCRIPTION OF OPERATIONS below $ E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 26731 WELD COUNTY ROAD 18, KEENESBURG, CO 80643 L;ANC:tLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF FORT COLLINS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 21 NORTH COLLEGE ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE FORT COLLINS CO 80522 RICHARD MARCHESINI, LUTCF ACORD 25 (2010105) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD