HomeMy WebLinkAbout210445 1986 ELECTRICcity of wheatridge certAGaRU® 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 : Next Insurance US Company 16285
INSURED
INSURER B: National Specialty Insurance Company 22608
1986 Electric
12119 Forest St
INSURER C :
INSURER D:
Thornton, CO 80241
INSURER E:
INSURER F:
DAMAGE TO RENTED 100,000.00
PREMISES Ea occurrence $
COVERAGES CERTIFICATE NUMBER: 7297267 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
NXTE6BB5H N -00 -GL
08/09/2021
08/09/2022
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 $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
N /A
NXTV3EDDM5-00-WC
08/18/2021
08/18/2022
X PER OTH-
STATUTE I ER
E.L. EACH ACCIDENT $ 500,000.00
E.L. DISEASE - EA EMPLOYEE $ 500,000.00
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT $1,000,000.00
Each Occurrence: $25,000.00
A
Contractors Errors and Omissions
X
NXTE6BB5HN-00-GL
08/09/2021
08/09/2022
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
7500 W 29th Ave
Wheat Ridge, CO 80033
0 0
;r
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
21 E
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ACORD 25 (2016/03)
@ 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
DORA
COLORADO
Department of
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 nasbastore@nasba.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_ticensing@state.co.us.
Colorado Department of Regulatory Agenc
Division of Professions and Occupations
Electrical Board
1986 Electric LLC
Electrical Contractor
EC.0102167 08/06/2021
Number Issue Date
Active 09/30/2023
Credential Status Expire Date
Verify this credential at: dpo.colorado.gov
Division Director'. Ronne Hines Cred nti old S nature
Colorado Department of Regulatory Agenc
Division of Professions and Occupations
Electrical Board
1986 Electric LLC
Electrical Contractor
EC.0102167 08/06/2021
Number Issue Date
Active 09/30/2023
Credential Status Expire Date
Verify this credential at: dpo.colorado.gov
Division Director: Ronne Hines C�d6Holder tun
1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800 F 303.894.7693 dpo.colorado.gov
-n
4 I
DORA
COLORADO
Department of
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 nasbastore@nasba.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_licensing@state.co.us.
Colorado Department of Regulatory Agencies
Division of Professions and Occupations
Electrical Board
Jeremy J Manzanares
Master Electrician
M E.3000799 08/03/2021
Number Issue Date
Active 09/30/2023
Credential Status Expire Date
Verify this credential at: dpo.colorado.gov
AAol-
Division Director, Ronne Hines Cre nti Holderii9daturf
Colorado Department of Regulatory Agenc'
Division of Professions and Occupations
Electrical Board
Jeremy J Manzanares
Master Electrician
ME.3000799
08/03/2021
Number
Issue Date
Active
09/30/2023
Credential Status
Expire Date
Verify this credential at: dpo.colorado.gov/�,,/�
livision Director: Ronne Hines
Crede tial blder S i n4t,n
1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800 F 303.894.7693 dpo.colorado.gov