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HomeMy WebLinkAboutT'S ELECTRIC LTD - INSURANCE CERTIFICATE (8)POLEMOU-02 CHMCRADY ACORO �� CERTIFICATE OF LIABILITY INSURANCE E (MM/D D/YYYY) 0DATE 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 endorsement(s). PRODUCER CONTACT Chris McRady N ME: PHONE FAX (ac, No, Ext): (307) 432-4153 (A/c, No): Wyoming Financial Insurance 1620 E Pershing Blvd, Ste 100 Cheyenne, WY 82001 ADDRLSS: cmcrady@WerCs.COm INSURERS AFFORDING COVERAGE NAIC # INSURER A: Em to ers Mutual Casualty Company 21415 INSURED INSURERS: INSURER C : Pole Mountain Electric, Inc. INSURER D : PO BOX 926 Cheyenne, WY 82003 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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 T TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM D POLICY EXP MM/D LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR FX] X 4D55669 06/16/2018 06/16/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED REMISES (Ea occurrence $ 500,000 MED EXP (Any oneperson) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: POLICY FX—] JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 4E55669 06/16/2018 06/16/2019 COMBINED SINGLE LIMIT 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE 4J55669 06/16/2018 06/16/2019 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ DED I X I RETENTION $ 10,000 Aggregate 2,000,000 A 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 / A 4X55669 WY STOP GAP 06/16/2018 06/16/2019 PER XUTE OTH- ER E.L. EACH ACCIDENT 1 000 000 $ — E.L. DISEASE - EA EMPLOYEE -------- $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 A Equipment Floater 4C55669 06/16/2018 06/16/2019 Leased/Rented 50,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mores ace is required) Automatic Additional Insured on the GL per form CG7174.3 if required by written contract. (Form available upon request) 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, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 6"A)*rt ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD