HomeMy WebLinkAboutT & T ELECTRIC CO INC - INSURANCE CERTIFICATE (4)ACORO"
PRODUCER
Western Group Inc. -Pueblo
511 W 10th St Ste A
P.O. Box 1958
Pueblo, CO 81002
George C. Shineovich
T&TEL-1 OP ID: SV
7TE(CERTIFICATE OF LIABILITY INSURANCE /YY)
06/2MM/DD/YY/YY
Phone: 719-543-3604 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURED T & T Electric Co Inc
Tim & Katherine Miller
1824 Aspen Circle
Pueblo, CO 81006-1489
rr)VFRAr:FC
INSURERS AFFORDING COVERAGE NAIC #
INSURERA. Liberty Mutual Insurance
INSURER B.
INSURER C:
INSURER D
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADD'
F
POLICY NUMBER
POLICY EFFECTIVE
DATEMM/DD
POLICY EXPIRATION
/
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
A
X COMMERCIAL GENERAL LIABILITY
BKW55359252
11/08/2017
1110812018
CA -AGE
REM SESOEa oocurence
$ 100,00
CLAIMS MADE Al OCCUR
MED EXP (Any one person)
$ 15,00
PERSONAL & ADV INJURY
$ 1,000,00
GENERAL AGGREGATE
$ 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,00
POLICY X PRO- LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
BAS55359252
11/08/2017
11/08/2018
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,00
X
BODILY INJURY
(PER PERSON)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(PER ACCIDENT)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(PER ACCIDENT)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS / UMBRELLA LIABILITY
EACH OCCURRENCE
$ 6,000,00
A
X OCCUR CLAIMS MADE
US055359252
11/08/2017
11/08/2018
AGGREGATE
$ 6,000,00
DEDUCTIBLE
$
$
X RETENTION $ 10,000
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
WC STATUOTH-
LIMIT-
E.L. EACH ACCIDENT
---
$
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
E.L. DISEASE - EA EMPLOYEE
$
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
ELECTRICAL WORK WITHIN BUILDINGS fax 970-224-6134
GLK 1 IFI(;A I It HULL)tK GANGtLLA I IUN
CITYFTC SHOULDANY OFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEEXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
CITY OF FT. COLLINS NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
330 S. COLLEGE AVE. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
P.O. BOX 580 REPRESENTATIVES. C4
FT COLLINS, CO 80522-0580 AUTHORIZED RE ENTATIVEGe-0'4 C.j$bj. AOVICh ft
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