HomeMy WebLinkAboutSPECTRUM PLUMBING INC - INSURANCE CERTIFICATE (3)A`oR0® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
12/132016
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 endorsements .
PRODUCER
FEDERATED MUTUAL INSURANCE COMPANY
HOME OFFICE: P.O. BOX 328
CONTACT
NAME: CLIENT CONTACT CENTER
A/OCNNo Ext : 888-333 4949 A/c No : 507-446 4664
ADDRESS: CLIENTCONTACTCENTER FEDINS.COM
OWATONNA, MN 55060
INSURERIS) AFFORDING COVERAGE
NAIC #
INSURER A: FEDERATED MUTUAL INSURANCE COMPANY
13935
INSURED 359-192-2
INSURER B:
SPECTRUM PLUMBING INC
INSURER C:
1825 W CASPIAN PL #6
ENGLEWOOD, CO 80110
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 46 REVISION NUMBER: 0
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
TYPE OF INSURANCE
ADDL
INSR
SUER
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE F OCCUR
N
N
9129200
01/31/2017
01/31/2018
EACH OCCURRENCE
$1,000,000
DAMAGE To RENTED
PREMISES Ea oC.'rence
$100,000
MED EXP (Any one person)
EXCLUDED
GEN'L
NOTHER:
PERSONAL &ADV INJURY
$1,000,000
AGGREGATE LIMIT APPLIES PER:
POLICY ❑ PRO ❑ LOC
JECT
GENERAL AGGREGATE
$2,000,000
PRODUCTS - COMP/OP AGG
$2,000,000
A
AUTOMOBILE
X
LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS.
NON -OWNED
HIRED AUTOS AUTOS
N
N
9129200
01/31/2017
01/31/2018
COMBIEa ccidNenEDt SINGLE LIMIT
a
$1,000,000
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
Per accident
A
X
UMBRELLA LIAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
N
N
9129201
01/31/2017
01/31/2018
EACH OCCURRENCE
$1,000,000
AGGREGATE
$1,000,000
DIED I I RETENTION
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
YIN ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
N
9129202
01/31/2017
01/31/2018
X
PER STATUTE
OTH-
ER
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
$500,000
E.L DISEASE -POLICY LIMIT
$500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required)
CERTIFICATE HOLDER CANCELLATION
359-192-2
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 80522-0580
460
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
(a 1988-2f114 ACORD CORPORATION. All rights reserved
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD