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HomeMy WebLinkAbout563480 WGL ENERGY SYSTEMS INC - INSURANCE CERTIFICATE (2)ACOR�� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/04,2017 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 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 Aon Risk Services, Inc. of Washington, D.C. 1120 20th Street NW CONTACT NAME i FAx (Awc. No. Ext): (866) 283-7122 (A)C. No.): (800) 363-0105 E-MAIL ADDRESS: Washington DC 20036 USA INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: The First Liberty Insurance Corporation 33588 WGL Enerav Systems, Inc. a Subsidiary of Washington Gas Resources 6862 Elm street, suite 300 INSURERB: Assoc Electric & Gas Ins Sery Ltd -AEGIS AA3190004 INSURER C: McLean VA 22101 USA INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570068858867 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. Limits shown are as requested LTR TYPE OF INSURANCE NSD WVD POLICY NUMBER MM DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY TB 41 1 1 1 EACH OCCURRENCE $ 500 , 000 CLAIMS -MADE X❑ OCCUR AMA RENTED PREMISES Ea occurrence %100,000 MED EXP (Any one person) $10, 000 PERSONAL &ADV INJURY $500,000 GEN'LAGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE $1,000,000 X POLICY ❑ PRO ❑ JECT LOC PRODUCTS - COMP/OP AGG $1,000,000 OTHER: AUTOMOBILE LIABILITY BINED SINGLE LIMIT CoEa accident BODILY INJURY ( Per person) ANYAUTO OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY PROPERTYDAMAGE Per accident B UMBRELLA LIAB OCCUR XL5035707P 10/01/2017 10/01/2018 EACH OCCURRENCE $2,000,000 rx EXCESS LIAB X CLAIMS -MADE AGGREGATE $2 , 000, 000 0 DED I RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY y / N PER OTH- STATUTE ER E.L. EACH ACCIDENT ANV PROPRIETOR / PARTNER / EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N / A E.L. DISEASE -EA EMPLOYEE (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Solar Photovoltaic System, Fort Collins lob Site: 1912 LaPorte Ave, Fort Collins, CO 80521. 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. CMof Of Fort Collins AUTHORIZED REPRESENTATIVE Utilities Department Attn: Norm weaver 970-221-6700 PO Box 580 /fa�:�1ury Fort Collins CO 80522-0580 USA cYYc�s�c%trviG, x�. cf `m r- cc m m CD 0 0 O Z 0) U d U ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD