HomeMy WebLinkAbout210443 ELECTRON MANAGEMENT SOLUTIONScertificate City_of_wheatridge (1)AGaRU® CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
05/17/2022
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 rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
CONTACT
NAME:
Next First Insurance Agency, Inc.
PO BOX 60787
Palo Alto, CA 94306
PHONE (855) 222-5919 FAX
A/C No Ext): A/C No):
E-MAIL support@nextinsurance.com
ADDRESS: pp
INSURER(S) AFFORDING COVERAGE NAIC #
INSURER A : State National Insurance Company, Inc. 12831
INSURED
INSURER B:
Electron Management Solutions
825 S Vance St Apt 101
INSURER C
INSURER D:
Denver, CO 80226
INSURER E:
INSURER F:
DAMAGE TO RENTED 100,000.00
PREMISES Ea occurrence $
COVERAGES CERTIFICATE NUMBER: 7814450 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
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X I COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE $1,000,000.00
CLAIMS -MADE OCCUR
DAMAGE TO RENTED 100,000.00
PREMISES Ea occurrence $
MED EXP (Any one person) $15,000.00
PERSONAL &ADV INJURY $1,000,000.00
A
X
NXTFNDJUN7-02-GL
10/16/2021
10/16/2022
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE $2,000,000.00
X POLICY ❑ PRO JECT ❑ LOC
PRODUCTS - COMP/OP AGG $2,000,000.00
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $
Ea accident
BODILY INJURY (Per person) $
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident) $
PROPERTY DAMAGE $
Per accident
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE $
AGGREGATE $
EXCESS LIAB
CLAIMS -MADE
DED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
PER OTH-
STATUTE I ER
ANYPROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? ❑
N/A
E.L. DISEASE - EA EMPLOYEE $
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT $
Each Occurrence: $25,000.00
A
Contractors Errors and Omissions
X
NXTFNDJUN7-02-GL
10/16/2021
10/16/2022
Aggregate: $50,000.00
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The Certificate Holder is City of wheatridge. This Certificate Holder is an Additional Insured on the General Liability policy per the Additional Insured Automatic Status
Endorsement. All Certificate Holder privileges apply only if required by written agreement between the Certificate Holder and the insured, and are subject to policy terms and
conditions.
CERTIFICATE HOLDER CANCELLATION
City of wheatridge LIVE CERTIFICATE
7900 E 29th Ave -
❑■ ❑■
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Denver, CO 80238 •.
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
r
AUTHORIZED REPRESENTATIVE
limi. -
Click or scan to view
ACORD 25 (2016/03)
@ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
COLORADO
�/ Department of co
�T�Y Regulatory Agencies
Division of Professions and Occupations
Below are your electronic wallet cards to use as proof of your license. You can also print your license at
any time by visiting www.colorado.gov/dora/DPO_Print_ License and following the instructions listed.
If you would like a more durable wallet card option, you can order one for a fee by visiting
www.nasbastore.org and selecting the "Colorado License Cards" link on the left hand side of the page. If
you prefer, you can also contact NASBA by phone at 1-888-925-5237 or by email at nasbastoregnasba.org.
Should you have questions about your credential, or need other information please contact our
Customer Service Team at 303-894-7800 or dora_dpo_licensinggstate.co.us.
Division of Professions and
Electrical Board
Electron Management Solutions
Electrical Contractor
EC.0101322 10/01/2020
Number Issue Date
Active 09/30/2023
Credential Status Expire Date
Verify this credential at: dpo.colorado.gov
Division of Professions and
Electrical Board
Electron Management Solutions
Electrical Contractor
EC.0101322 10/01/2020
Number Issue Date
Active 09/30/2023
Credential Status Expire Date
VeSify this credential at: dpo.colorado.gov
1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800 F 303.894.7693 dpo.colorado.gov
�� Wheat id e
COM MUNITy DEVELOPMENT
7500 W. 2911 Avenue' Wheat Ridge, CO 80033' O: (303)235-2855' F: (303)235-2857
Contractor Waiver for
Workers' Compensation Insurance
I, (print your name),
Javan Davis
verify that I am the sole owner or partner of (company name):
Electron Management Solutions LLC
which has no employees and is not required by the State of Colorado to
carry workers' compensation insurance.
I further state that if I hire contractors/subcontractors, they are in
compliance with the State of Colorado Workers' Compensation insurance
requirements, have obtained the required contractor's license from the City
of Wheat Ridge andwill he permit.
Signature:
Date: 05/17/2022