HomeMy WebLinkAboutUTILITY PARTNERS OF AMERICA LLC - INSURANCE CERTIFICATE (2)AC" ® DATE (MM(DD/YYYY)
V CERTIFICATE OF LIABILITY INSURANCE 9/10/2017
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 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 riahts to the certificate holder in lieu of such endorsement(s).
PRODUCER
4rthur J. Gallagher Risk Management Services, Inc.
4350 W. Cypress St, Suite 300
Tampa FL 33607
INSURED
Utility Partners of America, LLC
7636 Pelham Road, Suite B
Greenville, SC 29615
PROPHOL-01
7-797-4
INSURERA:WESCO INS CO
INSURER B :Technologv Insurance
INSURER E :
Nam,. 727-791-1613
25011
Inc 142376
rni/1=0AGGC CGDTILI(`ATF NI IIUlQr7D. 1 R7n97i5ii DF\/I4ZIf11U IUI IRAPPD.
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 POLICY EFF POLICY EXP LIMITS
LTR INSD D POLICY NUMBER MM/DDIYYYY MMIDDIYYYY
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
E
CLAIMS -MADE D OCCUR
AITAGTi�REN7C�
PREMISES (Ea occurrence
E
MED EXP (Any one person)
E
PERSONAL & ADV INJURY
E
GENT
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
E
POLICY JECT PRO ❑ LOC
PRODUCTS - COMPIOP AGG
E
E
OTHER:
AUTOMOBILE LIABILITY
-D SINGLE LIMIT
Ea accident)
E
BODILY INJURY (Per person)
E
ANY AUTO
OWNED ASCHEDULED
AUTOS ONLY UTOS
BODILY INJURY (Per accident)
E
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Per accident
E
E
UMBRELLA LIAB OCCUR
EACH OCCURRENCE
E
AGGREGATE
E
EXCESS LIAB CLAIMS -MADE
E
DIED RETENTION E
A
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
WWC3304821
TWC3655712
9/11/2017
9/11/2017
9/11/2018
9/11/2018
PER O -
X STATUTE ER
E1,000,000
E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
NIA
E.L. DISEASE - EA EMPLOYEE
_-- _--
E1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
------ _—
E.L. DISEASE - POLICY LIMIT
---- - - _--
$1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Waiver of Subrogation has been added in favor of the certificate holder, with regards to workers compensation, as required by written contract.
A Waiver of Subrogation in favor of the Certificate Holder applies to the Workers Compensation policy, when required by written contract and
where allowed by law.
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
222 Laporte Ave.
Fort Collins CO 80522
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
Oc 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD