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HomeMy WebLinkAbout210465 ADIONA TRANSPORTATION SOLUTIONCERTIFICATE OF LIABILITY INSURANCE DATE DDIY (MMI(MMID IY YYY) TYPE OF INSURANCE a 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: TI a Anderson Taggart & Associates, Inc. PHONE FAX 1680 38th Street AIc No Ext): 13034421484 AIC No): 303-442-8822 ADODRES& certificates@taggartinsurance.com Suite 110 INSURER(S) AFFORDING COVERAGE NAIC# Boulder CO 80301 INSURERA: The Cincinnati Specialty Underwriters Insurance Co 13037 $ 0 INSURED ADIOTRA-01 INSURER B: Artisan and Truckers Casualty 10194 Adiona Transportation Solutions, LLC GENERAL AGGREGATE $ 2,000,000 1213 Catalpa Place INSURER C: Landmark American Insurance Company 33138 INSURER D: Pinnacol Assurance 41190 Erie CO 80516 INSURER E: Auto -Owners Insurance Company 18988 INSURER F: 11/3/2021 11/3/2022 COVERAGES CERTIFICATE NUMBER: 523418743 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 MMIDDIYYYY POLICY EXP MMIDDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR CSU0172372 7/20/2022 7/20/2023 EACH OCCURRENCE $ 1,000,000 PREMISES DAMAGE TO PREMISES Ea occurrence) ccurrence $ 100,000 GEN'L MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT El LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS HIREDX NON -OWNED AUTOS ONLY AUTOS ONLY 953450764 11/3/2021 11/3/2022 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ C X UMBRELLA LAB EXCESS LAB X OCCUR CLAIMS -MADE LHA254202 7/20/2022 7/20/2023 EACH OCCURRENCE $ 3,000,000 AGGREGATE $ DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVEE.L. OFFICER/MEMBER EXCLUDED? N I (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4231937 8/1/2022 8/1/2023 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 E Equipment Floater 74239246-21 11/15/2021 11/15/2022 Ded. $250 750,000 DESCRIPTION OF OPERATIONS I LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 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 W 29th Ave AUTHORIZED REPRESENTATIVE Wheat Ridge CO 80033 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Colorado -Department of Regulatory Agencies Division of Professions and Occupations Electrical Board Kyle Money Christensen Master Electrician M E.0030663 Number Active Credential Status Verify this credential at: 10/01/2020 Issue Date 09/30/2023 Expire Date dpo. colorado. gov Division Director: Ronne Hines Creden't aC [Folder Signature ADIOTRA-01 CMORGAN r .- CERTIFICATE OF LIABILITY INSURANCE FDATE,(MM/DD/YYYY)8 /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 Taggart & Associates, Inc. 166638th Street CONTACT Tiya Anderson NAME: PHONE 303 442-1484 1259 FAX (A/C, No, Ext): ( ) (A/C, No): AILtanderson@taggartinsurance.com AD Suite 110 Boulder, CO 80301 INSURERS AFFORDING COVERAGE NAIC # INSURER A: The Cincinnati Specialty Underwriters Insurance Company 13037 INSURED INSURER B: Artisan and Truckers Casualty 10194 INSURER C: Landmark American Insurance Company 33138 Adiona Transportation Solutions, LLC INSURER D: Pinnacol Assurance 41190 1213 Catalpa Place Erie, CO 80516 INSURER E : North American Capacity Insurance Company 25038 INSURER F: Auto -Owners Insurance Company 18988 $ 2,000,000 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR 14- C;ea: CSU0172372 7/20/2021 7/20/2022 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence 100,000 $ MED EXP (Any oneperson) $ 0 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT E] LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED XSCHEDULED AUTOS ONLY AUTOS HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY 953450764 11/3/2021 11/3/2022 COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ X PROPERTY DAMAGE Per accident $ C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE LHA252776 11/11/2021 7/20/2022 EACH OCCURRENCE $ 3,000,000 X AGGREGATE $ 3,000,000 DED RETENTION $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE * OFFICER/MEMBER EXCLUDED? (Mandatory in NH) Ifyes, describe under DESCRIPTION OF OPERATIONS below N / A 4231937 7/20/2021 8/1/2022 X PER OTH- STATUTE ER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 $ E F Errors & Omissions Equipment Floater C-4LPA-033244-CYBER-2021 74239246-21 7/20/2021 11/15/2021 7/20/2022 11/15/2022 Per Claim Ded. $250 1,000,000 750,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Ridge Cit of Wheat Rid THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 7500 W 29th Ave Wheat Ridge, CO 80033 AUTHORIZED REPRESENTATIVE 14- C;ea: 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 Adiona Transportation Solutions Electrical Contractor EC.0102072 05/25/2021 Number Issue Date Active 09/30/2023 Credential Status Expire Date Verify this credential at: dpo.colorado.goy/ _ Division of Professions and Electrical Board Adiona Transportation Solutions Electrical Contractor EC.0102072 05/25/2021 Number Issue Date Active 09/30/2023 Credential Status Expire Date Verify this credential at: dpo.colorado.gov 1560 Broadway, Suite 1350, Denver, CO 80202 P 303.894.7800 F 303.894.7693 dpo.colorado.gov