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HomeMy WebLinkAbout112903 BRIAN'S ELECTRIC CO LLC - INSURANCE CERTIFICATE (3)02/01/2018 THU 11:54 FAX 0002/004 Fax:(970)221-6270 CERTIFICATE OF LIABILITY INSURANCE DATE (MMlDDIY1'YYi D210112018 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 CONTACT NAME: Jodi Witter Security Insurance Group, LLC PHONE 970-378-4818 FAAjX, No . 970-3784820 D RILSS jodi@securityinsurancegroup.net ADDRESS: 8219 W 20th St, Ste A INSURE S AFFORDING COVERAGE NAIC # Greeley, CO BD634 INSURER A: Auto OwnersInsurance 327 INSURED INSURER B: Owners Insurance Company 18988 INSURER C: Brian's Electric Co, LLC INSURER D : 1410 Webster Ave INSURER E: Fort Collins, CO 80524-4718 INSURER F : COVERAGES CERTIFICATE NUMBER: 00000000-990517 REVISION NUMBER: 203 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOV! HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 SUBR POLICY NUMBER POLICY EFF MM DD POLICY EXP MM DD LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE� OCCUR Y Y 74103606 03/0312018 03103/2019 EACH OCCURRENCE $ 1,000,000 P AGE O N er ) $ 300,000 MED EXP (Any one person) $ 10 000 PERSONAL & ADV INJURY $ 1 DOD DDD GEN'L AGGREGATE LIMIT .APPLIES PER PRO- LOG POLICY J OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS $ 2,000,000 $ A AUTOMOBILE X 1) LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY .AUTOS HIRED NON -OWNED AUTOS ONLY .AUTOS ONLY L Y Y 4941848602 03/0312018 03103/2019 (EaaccdEeDSINGLELIMIT $ 1 DDD DDD BODILY I NJURY(Per parson) $ BODILY INJURY(Per accident) $ PROPERTY DAM AGE P e $ 1 $ I3 X UMBRELLALIAB EXCESS LIAR X OCCUR CLAIMS -MADE 4941848601 - 03/0312018 0310312019 EACH OCCURRENCE $ 1,0D0,090 AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRI ETORIPARTNERIEXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA I PER OTH- TAT UTE E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY UMIT $ A Rented Equipment 74103606 0310312018 03/0312019 50,09D DESCRIPTION OF OPERATIONS! LOCATIONS (VEHICLES (ACORD 101, Additional Remarks Schedule. may be anached if wore space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Streets Department ACCORDANCE WITH THE POLICY PROVISIONS. 625 9th St. AUTHORIZED REPRESENTATIVE t Fort Collins, CO 80524 tV7 kw .. t.1f.f} f'. t JM ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Printed byJMW on February 01, 2018 at 11:42AM