HomeMy WebLinkAboutNORTHWEST LINEMAN COLLEGE - INSURANCE CERTIFICATE 2023-2024�7
ACORi7"' CERTIFICATE OF L�ABILITY INSURANCE °"TE�""�,°°"�"'
��� 5/1/2024 04/25/2023
THIS CER71F'�CATE IS ISSUED AS A MATTER OF INFORMATION QNLY ANQ CONFERS NO RIGHT3 UPON 'FHE CERTIFICATE HOLDER. THIS
EERTIFlCATE �pES NOT AFF1R1r4ATIVELY OR NEGATIVELY AMENd, EXTEND OR ALTER THE COVERAG� AFFORDED BY THE POLICIES BELOW.
THIS CERTIFICATE Qf INSURANGE DOES NOT COtJSTIiU7E A CONTRACT BETWEEN THE ISSUING iNSURER(5), AUTHORiZED REPRES�M7A7Rl�
OR PRO�UCER, AND THE CERTIFICATE HO��ER.
IMPORTANT: if the certificata holder is an AD�1TIOtJAL INSUREU, the polacy(ies) must have An�lTIONAL iNSURED provEsfons or be endorsed, li
SUBROGATION IS WAIVED, subjact to the terms and condilions of the policy, certain policies may require an endorsement. A statement on thEs
certificate does nat confer rights to the certificafe holder In lieu of such endorsement{sj.
PRp�UCER LOCKTON COMPANIES
3657 BRIARPARK bRIVE, SUITE 70D PHQNE
Houston TX 77042 E-MAIL
INSURER S AFFORDING CO{lERAGE NAIC q
iNsnReRn: Old Rep�blic insurance Company 24147
�NsuReo Grid Training Corporation INSURER B:
365788 dba Northwest Lineman College INSURER C:
a Quanta Services Company 1NSURER D:
7600 S. Meridian Road
Meridian IQ 83642 INSURER E:
INSURER F :
COVEFtAGES EJAN03 CER'F[FICATE NUldlBER: 'I6'IOB387 REVISION NUMBER: XXXX�(X
THIS IS TO CERTIPY THAT THE POLICI�S bF INSURANCE LISTED BELdW HAVE BEEN ISSUE� TO TH� lIVSUREp NRMEp ABOVE FOR 7HE POLICY
PERI06 IN�ICATED. NOTWITFf5iANDING ANY REQUIREMENT, T£RM pR GONDI71aN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
WHICH THIS CERTIFICATE MqY 8E ISSUEp OR MAY PERTAfN, THE INSURANCE AFFdRDED BY THE POLICIES �ESGRIBED HEREIN IS SUBJECT TO
INSR ObL SUB POLICY EFF POLICY E7(P
LTR TYPE OF [NSURANCE IN$D YWO POlICY NUMBER MM![ID MMID� LIMITS
X COMM�RCIAL GENERAL LIABILIIY MWZY 313093 23 05 01 202 05 01 242 EqCFt OCCURRENCE s') 000 ODO
CLAIMS-MpDE � OCCUR S 3 000 ODO
�
Y N MED EXP An one BrBon s Excluded
PERSONAL 8 ADV INJURY s'I QOO ODO
GEN'LAGGREGATELlMITAPPLIESPER; GENERALAGGREGATE s � OOOOOO
POLICY� �Ea �LOC PROOUGTS-COMPlOPAGG s'I OOO OOO
OTHER: $
A Al1TOMO6ILE LUIBILITY MWFB 313092 23. D5l011202 05I0112Q2 � eBI�.NE�DtSINGLE LIMIT S,�'040 00�
X ANY AU70 60DILY INJURY {Per perspn) S)OO(�(XX
X OWNED SG1i�PULEP Y � BOD0.Y INJURY (Per accident S)QQQ(�(X
AUTOS ONl.Y AUTOS
X HIREp X MON-OWMED PppPER7Y AMAGE
AUTOS ONLY AUTOS ONLY Qer acadent f iCiCiCXX�
S XXXXX)(X
tlMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE S)OOO(�(X
EXCE33 LIAB CLAJMS-MA�E AGGREGATE S XXXXiO(X
DEO RETENTIqN 5 S
WORKERS CDMPENSA710N X
A ANn EMPLOYERS' LIAB[LfTY Y! N MWC 3i3094 23 05I011202 05101l2D2 �
AN'f PROPRIEfOEUPARTNERIEXECifTIVE S 1�00 OOQ
OFFICERIMEMBEREICCLUOE�'! ❑N N!A N E.L.EACHACCIDENT
�M�ndam�y In HHF E.L. OISERSE - EA EMPLOYEE a 1 000 D00
�E�SCRI� OvF OPERATIONS bebw EL OISEASE - POLICY l,IMfT a 1 D00 OOd
DESCRIPTION OF OPERATIONS ! LOCATIONS! YEHICLES (ACDRU 101, AdditEonal Ramarks Schedule, may be attached if mora apaea Is requlred)
RE: Project StaAlEnd Dates: 6111-6l12. Addilional Insured in favor of City of Fort Collins, its offrcers, agents, and employees {on al) policies except Workers'
CompensationlEL) where and tp Ihe extent required by written contracl. 30 Day Notite of CancelEalivn is included on a!1 policies.
SHOULD ANY OF THE ABOVE �ESCRlBEp POI.ICIES BE CANCELLE� BEFORE
THE EXPIRATlON �ATE THEREOF, NOTfCE WfLL BB �HLNERE� IN
ACCORDANCE WITH THE pOLICY PROVISIONS.
16106387
City of Fort Collins
700 Wood Street
FoR Collins CO 80521
AUTHOR¢ED REPRESEI'}TATIVE
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ACORD 25 (2016l03j The ACORD name and ioga are registered marks of ACORD