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HomeMy WebLinkAboutTEPA LLC - INSURANCE CERTIFICATE (4)30305 AC" CERTIFICATE OF LIABILITY INSURANCE DATE/YYYY) 2/28/208l2017 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 NAME: Arnie Schans _._ Commercial Lines - (800)-332-9256 PHONE - - _ FAX (A/C, Nqs ExW 303 863 4651 Aro No : 855-669-8729 Wells Fargo Insurance Services USA, Inc. E-MAIL Arnold.Schans wellsfar o.Com _ ADDRESS: C 9 90 S. Cascade Ave, 2nd Floor INSURER(S) AFFORDING COVERAGE NAIC # Colorado Springs, CO 80903 INSURER A: Old Republic Insurance Company _ 24147 INSURED INSURER B : Travelers Property Casualty Co of America 25674 Tepa,LLC INSURER C 5045 List Drive INSURER E : _ Colorado Springs, CO 80919 INSURER F COVFRAGFS CFRTIFICATF NI IMRFR• 11512769 RFVISIr1Iv Al11MRFR• Saa halnw 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 SUBIR _ POLICY NUMBER POLICY -El MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR MWZY 309532 3/1/2017 3/1/2018 EACH OCCURRENCE $ 1,000,000 __ _ DA G€SZS REN'PE� PREMISES Ea occurrence _ _ $ 500,000 MED EXP (Any one person) S 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY X❑ PE� E] LOC PRODUCTS - COMPIOP AGG $ 2,000,000 S OTHER: A AUTOMOBILE LIABILITY MWTB 309531 3/1/2017 3!1l2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) 5 X PROPERTY DAMAGE Per accident $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY 5,000 Med Pay $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? C (Mandatory in NH) N/A MWC309530 3/1/2017 3/1/2018 PER OTH- x STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E L DISEASE - EA EMPLOYEE S 1,000,000 It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 B Installation Leased/Rented Equipment 660367M779ATIL17 3/1/2017 3/1/2018 $z50,000 $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is recognized as an additional insured as respects: Contractors License fax:970-224-6134 GtK 1 II-IGA It HtJLUtK City of Ft. Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN P.O. Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins CO 805220580 AUTHORIZED REPRESENTATIVE 9(-a, The ACORD name and logo are registered marks of ACORD ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) I IIIIIII III IIIIIII IIII IIIII ullll IIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIIII IIII IIII •CYB01A03/001049/02J02/0M/0/0'