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ACO CERTIFICATE OF LIABILITY INSURANCE (� DATE(MWDDNYYY)
`66� 5111202504/23/2024
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 pollcy(les) 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 LOCKTON COMPANIES
3657 BRIARPARK DRIVE, SUITE 700
HOUSTON TX 77042
866-260-3538
INSURER A: Old Republic Insurance Company 124147
INSURED PROBST ELECTRIC, INC.
1365788A QUANTA SERVICES COMPANY
441 W POWERLINE RD
HEBER CITY UT 84032
COVERAGES CERTIFICATE NUMBER: 2nfIR nio R1=WS!ON NI IRARGR• YYYYYYY
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 REOUIREMENT, 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
POLICIES.ACLAIMS,
INSR
LTR
TYPE OF INSURANCE
ADDLSUBR
INSD
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY)
POLICY EXP
(MWDDNYYYI
LIMITS
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
Y
N
MWZY 313093 24
05/01/202
05/01/202E
EACH OCCURRENCE
$ 1 000 000
S 1 000 000
MED EXP An Ram
on) aon
$ Excluded
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER
POLICY JE � LOC
OTHER
GENERAL AGGREGATE
$ 1.000.000
PRODUCTS - COMPIOP AGG
$ 1,000,000
$
A
AUTOMOBILE LIABILITY
X ANY AUTO
OWNED X AUTOS ONLY AUTOS
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
Y
N
MWTB 313092 24.
05/01/202
05/01/202
(CEO,aocl d.n j.,NED LIMIT
$ 11000,000
BODILY INJURY (Per person)
$ XXXXXXX
BODILY INJURY (Per accident)$XXXXXXX
PROPERTY AMAGE
Per accident
$ XXXXXXX
$XXXXXXX
UMBRELLA L1AB
EXCESS LIAB
OCCUR
CLAIMS -MADE
NOT APPLICABLE
EACH OCCURRENCE
$ XXXXXXX
AGGREGATE
$ XXXXXXX
DIED i I RETENTION S
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIET
OFFICERIMEMSEWPARTNERFEXR EXCLUDED? ECUTIVE
Mandatory In NH) FRI
If yes, describe under
uM
DESCRtPTION OF OPERATIONS Wow
N J A
N
MWC 313094 24
05/01/202
05/01/202
X -
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - E4 EMPLOYEE
$ 1,000,000
E.L- DISEASE - POLICY LIMIT
$ 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: City of Hayes Water Distribution Job Number 31001300500 Additional Insured in favor of City of Caldwell on the General Liability and Auto Liability whore and to Ire
extent required by written contract.
a.�n r rrwn r � nvw�n l,AryI,,CLLR I IVry
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
20068010 T12P1 AUTHORIZED REPRESENTATIVE
City of Caldwell
PO Box 1179
Caldwell ID 83605
rights reserve
AUUKU Lb (ZUTbIUJ) I ne AUURD name and logo are registered marks of ACORD