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HomeMy WebLinkAboutSIMPSON ELECTRIC INC - INSURANCE CERTIFICATE (16)SIMPELE-01 RFISHER ACORO CERTIFICATE OF LIABILITY INSURANCE DAT DIYYYY) 3/271227/2017 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 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 NAME Dave Owen TrueNorth Companies, LC PHONE (303) 778d122 A� No: (303) 776-5495 275 South Main Street, Suite 100 AIC Ell: No E: Longmont, CO 80501 ADDRESS: dowen@truenorthcompanies.com INSURED Simpson Electric, Inc dba Simpson Electric of Colorado PO Box 2196 Loveland, CO 80539 INSURER(S) AFFORDING COVERAGE NAIC 1t INSURER A: Owners Insurance Company 32700 wsuRER9:Auto Owners Insurance Company 18988 INSURER C: Pinnacol Assurance COmpany 41190 INSURER D , INSURER E : rnVFROr,FS CFRTIFICOTF NIIMRFR- REVISION NUMRFR- 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. ILTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM DDY MIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE E� OCCUR X 74144089 04/01/2017 04/01/2018 $ 300,00 PREMISES Eaoccu ence $ 5,00 MED EXP (Any one person) PERSONAL & AOV INJURY $ 1,000,00 GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: $ 2,000,00 X POLICY F PRO JECT ❑ LOC PRODUCTS _ S 2,000,00 OTHER $ AUTOMOBILE LIABILITY O BINEDISINGLE LIMIT (EaA $ 1,000,00 BODILY INJURY (Per person) X ANY AUTO 268665900 04101 /2017 04/01/2018 $ - - ALL OWNED SCHEDULED - $ BODILY INJURY (Per acdder� AUTOS AUTOS PROPERTY DAMAGE $ NON -OWNED HIRED AUTOS AUTOS Peracciderrt $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE _ B EXCESS LIAS ] CLAIMS -MADE 268665901 04/01/2017 84/01/2018 $ 1,000,000 DIED I X I RETENTION $ 6,000 $ WORKERS COMPENSATION XI PER H AND EMPLOYERS' LIABILITY YIN STATUTE ER C ANY PROPRIETOR/PARTNER/EXECUTIVE 182129 04/01/2017 04/01/2018 E.L EACH ACCIDENT $ 1,000,00 OFFicER/MEMBER EXCLUDED? (Mandatory In NH) N f A — -- - E.L. DISEASE - EA EMPLOYEE - - $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as Additional Insured with regards to General Liability, where required by written contract or agreement, per policy forms and endorsements. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Attn: Laurie 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 UT ",4 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD