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HomeMy WebLinkAbout506424 EXCERGY CORPORATION - INSURANCE CERTIFICATE (2)A � CERTIFICATE OF LIABILITY INSURANCE 5ii4/2018 THIS CERTIFICATEIS 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 SELECTSOLUTIONS INS SRVCS LLC/PHS 101077 P: (866) 467-8730 F: (888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONFACT NAME: w°NEo,Ext): (866) 467-8730 is .No) (888) 443-6112 ADDRESS INSURER(S) AFFORDING COVERAGE NAICN INSURERA: Sentinel Ins CO LTD INSURED EXCERGY CORPORATION 3773 E CHERRY CREEK NORTH DR STE 575 DENVER CO 80209 INSURER B : INSURER C INSURER INSURERE: 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. LNSR TYPE OFEVSUBANCE ADDI SURA POLILTNUMBEX POLICYEFF MM/UD/YYY POLICYLxP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE g2 r 000, 000 CLAIMS -MADE � OCCUR DAMAGE TO RENTED PREMISES Ea occurrence) 51 000, 000 r X X MED EXP (Any one person) $10r000 A General Liab 57 SBA ID2750 06/09/2018 06/09/2019 PERSONAL& ADV INJURY s2r 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY � PRO [_X] LOG JECT GENERAL AGGREGATE 5 4, 000, 000 PRODUCTS - COMP/OP AGG s4, 000, 000 OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) 52 0 0 0 000 r 1 BODILY INJURY (Per person) ANY AUTO F OWNED SCHEDULED AUTOS ONLY AUTOS $7 SBA ID2750 06/09/2018 06/09/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $1 r 000, 000 A EXCESSLIAB CLAIMS -MADE 57 SBA ID2750 06/09/2018 06/09/2019 AGGREGATE $1, 000, 000 DE X I RETENTION $10 , 0 0 0 WORKERS COMPENSN1ION AID F.MPLor"J LL—ILny PER OTH- SrATUTE ER E.L. EACH ACCIDENT ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED? (Arandatory in NH) ❑ N A E.L. DISEASE- EA EMPLOYEE $ If yes, describe under EL DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS /LOCATIONS / VEH/OJIIMRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. City of Fort Collins, its agents, officers, and employees are named as additional insured while acting under the direction of the City of Fort Collins per the Business Liability Coverage Form SS0008 attached to this policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins 700 WOOD ST AUTHORIZED REPRESENTATIVE FORT COLLINS, CO 80521 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD