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HomeMy WebLinkAbout210466 KZ ELECTRIC INCCIty of Wheat Ridge COI (7)KZELE-1 OP ID- TA AC"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 0610612022 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 303-691-9100 Manor Insurance Agency, Inc 1325 S Colorado Blvd Ste 210 CONTACT NAME: HONE (A/C, No, Ext): 303-691-9100 FAX No):303-691-2565 E-MAIL ADDRESS: Denver, CO 80222 INSURERS AFFORDING COVERAGE NAIC # 0711812022 INSURER A: Ohio Security Insurance Comp. 24082 INSURED KZ Electric Inc. INSURER B: The Hartford 30104 MED EXP (Any oneperson) $ 15'000 Joshua Hansen 5445 W Colorado Ave. INSURER C: $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY El PET [:]LOC OTHER: GENERAL AGGREGATE Lakewood, CO 80232 INSURER D: $ 2,000,000 $ A INSURER E: LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNE AUTOS ONLY AUTOS ONLY INSURER F: BAS60115782 COVERAGES CERTIFICATE NUMBER- 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 TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF POLICY EXPITR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [ OCCUR BKS60115782 0711812021 0711812022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 300,000 $ GENT MED EXP (Any oneperson) $ 15'000 PERSONAL &ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY El PET [:]LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS $ 2,000,000 $ A AUTOMOBILE X LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON-OWNE AUTOS ONLY AUTOS ONLY BAS60115782 0411912022 0411912023 COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILYINJURY Perperson) $ BODILY INJURY Per accident $ OPTY FIR RER Per accidentDAMAGE $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED FFRETENTION $ I3 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVELlE.L. OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 34WECASOORL 0410412022 0410412023 X PER OTH- STATUTE ER EACH ACCIDENT 1,000,000 $ E.L. DISEASE- EA EMPLOYEE $ 1,000,000 E.L. DISEASE- POLICY LIMIT 1,000,000 $ DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION CITYWHE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Wheat Ridge ACCORDANCE WITH THE POLICY PROVISIONS. 7500 West 29th Avenue AUTHORIZED REPRESENTATIVE 1_1J_ ` n-4 Wheat Ridge, CO 80030 ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD n05•opeJojoa•odp £69L•168•EO£ 3 008L1,68•£0£ d ZOZ08 Oa `JanuaO `OS£l a1!nS 'AeMpeoJg 09S l aJnleuaiS Jap off 4e!IuLaPaX sau!H auuoa.:JoaaaJld uo!sin!(l �A.Z-ep!dp :le jetluapaJo s!gl (;uaA a;e0 aJidx3 snjejS le!;uapaJ:) £ZOZ/0E/60 a^!l:)V area anssl JagwnN OZOZ/10/01 9b91010'D3 J0PeJluoale:)ul:)al3 aul Juha13 ZN Peog IeD!Jl:)al3 suoilednaa0 pue suoissaloJd 10 uoisinia saiauaSV AJo;eln5aa 10 juawliedad opeJolo:) unjeugiS J jOH quapaJ sau!H auuob. 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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 Agencie! Division of Professions and Occupations Electrical Board Joshua Adam Hansen Master Electrician ME.0601189 10/01/2020 Number Issue Date Active 09/30/2023 Credential Status Expir Dat Verify this credential at: dpo.co�clq%ov7 r Signature Colorado Department of Regulatory Agencies Division of Professions and Occupations Electrical Board Joshua Adam Hansen Master Electrician M E.0601189 10/01/2020 Number Issue Date Active 09/30/2023 Credential Status Expire Date Verify this credential at: dpo.c ra gov i 1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800 F 303.894.7693 dpo.colorado.gov