Sei sulla pagina 1di 1

DATE (MM/DD/YYYY)

CERTIFICATE OF LIABILITY INSURANCE

1/29/2016

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 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).
CONTACT
NAME:
FAX
PHONE
(A/C, No): (602)419-2242
(A/C, No, Ext): (602)753-4250
E-MAIL
ADDRESS: certificates@resecoadvisors.com

PRODUCER

Reseco Insurance Advisors, LLC


7901 N. 16th Street
Suite 100
Phoenix
AZ 85020

INSURER(S) AFFORDING COVERAGE

NAIC #

Acadia Insurance Company


INSURER B :Continental Western Ins Co
INSURER C :Union Insurance Company

31325
10804
25844

INSURER A :

INSURED

Tap & Sons Electric Inc


PO BOX 804

INSURER D :
INSURER E :

Gilbert

AZ 85299

INSURER F :

CERTIFICATE NUMBER:15/16

COVERAGES

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 SUBR
INSR WVD

POLICY NUMBER

POLICY EFF
POLICY EXP
(MM/DD/YYYY) (MM/DD/YYYY)

GENERAL LIABILITY

X
A

COMMERCIAL GENERAL LIABILITY


CLAIMS-MADE

CPA454896215

OCCUR

GEN'L AGGREGATE LIMIT APPLIES PER:


PROPOLICY
LOC
JECT

4/15/2015 4/15/2016

X
X
B
C

ANY AUTO
ALL OWNED
AUTOS
HIRED AUTOS

UMBRELLA LIAB
EXCESS LIAB

MED EXP (Any one person)

PERSONAL & ADV INJURY

GENERAL AGGREGATE

PRODUCTS - COMP/OP AGG

COMBINED SINGLE LIMIT


(Ea accident)
BODILY INJURY (Per person)
SCHEDULED
AUTOS
NON-OWNED
AUTOS

CPA454896215

4/15/2015 4/15/2016

$
$

Med Pay

OCCUR

EACH OCCURRENCE

CLAIMS-MADE

AGGREGATE

A Leased/Rented Equipment

CUA455729314

4/15/2015 4/15/2016
WC STATUTORY LIMITS

OTHER

E.L. EACH ACCIDENT

4/15/2015 4/15/2016

CPA454896215

4/15/2015 4/15/2016

1,000,000
1,000,000

X
WCA454896714

1,000,000

BODILY INJURY (Per accident) $


PROPERTY DAMAGE
(Per accident)

DED
RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
N/A
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below

1,000,000
100,000
5,000
1,000,000
2,000,000
2,000,000

PPA Max $5M

AUTOMOBILE LIABILITY

LIMITS

EACH OCCURRENCE
DAMAGE TO RENTED
PREMISES (Ea occurrence)

E.L. DISEASE - EA EMPLOYEE $


E.L. DISEASE - POLICY LIMIT
Limit
Deductible

1,000,000
1,000,000
1,000,000
10,000
500

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)

CERTIFICATE HOLDER

PROOF OF INSURANCE

CANCELLATION
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

Steve Hanrahan/KELLNI
ACORD 25 (2010/05)
INS025 (201005).01

1988-2010 ACORD CORPORATION. All rights reserved.


The ACORD name and logo are registered marks of ACORD

Potrebbero piacerti anche