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HomeMy WebLinkAboutBENCHMARK ELECTRICAL SOLUTIONS INC - INSURANCE CERTIFICATE (8)DATE (MM/ DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/30/2017 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 K lie Care CISR NAME: y Carey, Flood and Peterson PHONE IA()lCNo:(970)506-6845 PO Box 578 ADMRIEss:KCarey@floodpeterson.com Greeley CO 80632 INSURER A :Kinsale Insurance Company 138920 INSURED INSURERS :Continental Western Group. Benchmark Electrical Solutions, Inc. INSURERC-Travelers Insurance Company 3665 Canal Drive, Unit A INSURERD: INSURER E : Fort Collins CO 80524 1 INSURERF: rnVFRARFC rr-PTIFIrATF NI IMRFRCL1753017929 RFVISION NIIMRFR- 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 TYPE OF INSURANCE ADDL SUBfi'•:— LTR V _ POLICY NUMBER POLICY EFF I POLICY EXP MM/DDIYYYY ? MM/DD/YY LIMITS X ;COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 100,000 A #CLAIMS -MADE X OCCUR __$ MED EXP (Any one person $ Excluded 01000392991 6/1/2017 { 6/l/2018 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO- POLICY X PRO- LOC ,. [PRODUCTS COMP/OP AGG $ .._.. 2,000,000 OTHER: ' Pollution Liability l $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 $ Ea accident 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ B ALL OWNED SCHEDULED IAUTOS AUTOS 063607 6/1/2017 6/1/2018 BODILY INJURY (Per accident) $ NON OWNED X # X AUTOS HIRED AUTOS '_ PROPERTY DAMAGE Per accidents—__ $ Medical payments $ 5,000 X ; UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,000 A I EXCESS LIAB CLAIMS MADE AGGREGATE $ 5,000,000 DED i X RETENTION$ 10,000 01000393041 6/l/2017 6/1/2018 $ WORKERS COMPENSATION WCA3137823 AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORiPARTNER,'EXECUTIVE OFFICERiMEMBER EXCLUDED? NIA 'All States Coverage i E.L. EACH ACCIDENT 3 $ 1,000,000 B (Mandatory in NH) ! = WCA3142664 - PA Only 6/l/2017 6/1/2018 E.L. DISEASE - EA EMPLOYE $ 1 000 000 B es. describe under DESCRIPTION OF OPERATIONS below i ` Excluding: OH, ND, WA, WY '___""_ "' i E.L. DISEASE -POLICY LIMIT € $ 1,000,000 C ;Excess Liability ZUP81M5951917NF t 6/1/2017 611/201B $5,000,000!$5,000.000 B I. Leased/Rented Equipment # CPA3063807 6/1/2017 6/1/2018 $250,000Limit DESCRIPTION OF OPERATIONS t LOCATIONS! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It more space is required) lyaa112L91t\67iNJA91i • City of Fort Collins, CO P.O. Box 580 Fort Collins, CO 80522-0000 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 K Carey, CISR/KCAREY `2 �� ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 r?n14n1 i