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Home My WebLink About584817 E3 SOLUTIONS INC - INSURANCE CERTIFICATEACORO� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) ��- 04/12/2018 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 Donna Martinez NAME: Terril Lewis & Wilke Ins A/CONNo Ext : (509) 248 3515 A/C, No): (509) 248-3673 P O Box 1789 E-MAIL dmartinez@tlwins.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # 112 S 4th Street Yakima WA 98907 INSURER A : Scottsdale Insurance Company Scic INSURED INSURER B : Western National Mutual Insurance Co 15377 INSURER C e3 Solutions, Inc INSURER D PO BOX 72 INSURER E : INSURER F : Yakima WA 98907 COVERAGES CERTIFICATE NUMBER: 18-19 GAS 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 LTR 7ypE OF INSURANCE INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE � OCCUR PREMISES Ea occurrence) ccurrence $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL s ADV INJURY $ 1,000,000 A CPS3052523 04/14/2018 04/14/2019 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 RPOLICY rX_1 PRO JECT ❑ LOC PRODUCTS - COMP/OP AGG $ 2,000,000 Stopgap $ 1,000,000 OTHER: I I AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO B OWNED SCHEDULED AUTOS ONLY AUTOS CPP1134456 04/14/2018 04/14/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Medical payments $ 5,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LIAB DED RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY r / N ANY PROPRIETOR/ER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? EXCLU (Mandatory in NH) N / A CPS3052523 04/14/2018 04/14/2019 PER oTH- STATUTE ER WA Stop Gap E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMrr 1,000,000 $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) L�faC\�IiPfG\�a•iI�JA�IaC 9G]LL91��G1�PJC The City of Fort Collins Purchasing Department 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 @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD