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Home My WebLink About125947 PTACEK ENTERPRISES INC DBA BATTERIES PLUS - INSURANCE CERTIFICATE (6)ACORO8 C" CERTIFICATE OF LIABILITY INSURANCE DATE (M MIDDIYYYY) 6/30/2017 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 endorsements . PRODUCER Molyneaux Insurance Inc. 5025 Utica Ridge Rd, Ste 100 Davenport IA 52807 NAME: CT Stacy Paisley P"°NE 563-324-1011 FAx 563-324-7909 E-MAIL . stacy.paisley@molyneaux.com INSURERS AFFORDING COVERAGE NAIC # INSURERA:Travelers Property Casualty Ins Corn 36161 INSURED PTACENT-01 INSURERB:The Standard Fire Insurance Co 19070 Ptacek Enterprises, Inc. dba Batteries Plus Bulbs 1107 W. Drake, Unit E-3 INSURERC: INSURERD: Fort Collins CO 80526 INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER. 2134029055 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 ADDL�SUBR INSD WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X� OCCUR Y 6802289W988 8/8/2017 8/8/2018 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED PREMI ES Ea occurrence $300.000 MED EXP (Any one person) $5,000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY jE O- LOC OTHER: GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP/OP AGG $4.000,000 $ A AUTOMOBILE LIABILITY ANY AUTO AUTOSNED AUTOSULEDBODILY HIRED AUTOS X NON -OWNED AUTOS Ix BA615D3648 8/8/2017 8/8/2018 Ea accident $1,000,000 BODILY INJURY (Per person) $ INJURY (Per accident) $ PR PER DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESSLIAB X OCCUR CLAIMS -MADE CUP2061 W503 8/8/2017 8/8/2018 EACH OCCURRENCE $1,000,000 AGGREGATE $1,000,000 DED I X I RETENTION$ 5,000 $ S WORKERS CCIMP NSATIC+. AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑Y (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below 1 N / A UB4J0209 1,4 Ei 6/2017 o/$i21113 X PER OTH STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 I E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) lya:41l20Jt1I13;L91. 9JAV Fort Collins Utilities 700 Wood St Fort Collins CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THORIZED REPRESENTATIVE @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD