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Home My WebLink About114215 MERIT ELECTRIC INC - INSURANCE CERTIFICATE (13)A� O® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDlYYYY) 6/22/2017 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 Jennifer Winter CISR NAME: PHOUVC_NENo, (970)506-3206 gA(CNo:(970)506-6846 Flood and Peterson ADDRESS:JWinter@floodpeterson.com PO Box 578 INSURERS AFFORDING COVERAGE NAIC # INSURER A Westfield Insurance Company 24112 Greeley CO 80632 INSURED INSURER B :Pinnacol Assurance 41190 INSURERC: Merit Electric, Inc. INSURERD: 2643 Midpoint Drive, Suite F INSURER E : INSURER F : Fort Collins CO 80525 COVERAGES CERTIFICATE NUMBER:CL1762218413 REVISION NUMBER: 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 D POLICY NUMBER MM/DDIYYYY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 500,000 X MED EXP (Any one person) $ 10,000 PD Ded: 5 , 000 CtMt4691001 7/1/2017 7/1/2018 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY J JE� LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1t000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWSCHEDULED AUTOS AUOWNED TOS NON -OWNED X HIRED AUTOS Ex AUTOS CiMS4691001 7/1/2017 7/1/2018 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X Drive Other Car X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION$ 0 $ CtM14691001 7/1/2017 7/1/2018 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NI (Mandatory in NH) NIA 4070414 7/1/2017 7/1/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 11000 00 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, descnDe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Fort Collins Light & Power 700 Wood Street Fort Collins, CO 80525 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 J Winter, CISR/JWINTE ACORD 25 (2014/01) INS025 rgmanti U 1983-2014 AGURU GORPURATIUN. All rights reserves. The ACORD name and logo are registered marks of ACORD