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HomeMy WebLinkAbout345637 C & R ELECTRICAL CONTRACTORS - INSURANCE CERTIFICATE (4)12/22/2004 0e:01 3034509648 C R ELECTRIC PAGE 03 KELLER LOWRY INS INC 3USf7(>0010 Isrc( v* I • + — - ,�Q$!�, CERTIFICATE OF LIABILITY INSURANCE is/ZVZZ o PN (03) 75 - 09 Rix (303 %T6-6616 THIS 0910WrTE IS I FORMATION N ONLYANDcNFER5NRI6NU ffftJATE Kellar -Lawry insurance Inc TECOVBRAGPEADOEe NOTTMPL MIND OR 177i 5 Harrison St i00 AR F E Denver, CQ $0210 INSURERS aFFt)RDIN®CpYERA6E NAIL 8 C 6 N Electricel Ga„tractors, P,O. am 3344d Northglenn, CO 80233 I TYPROrNHIMAiIOR NIAAI4ER r ulnrs A 4 olMRRAL LLAeRIT' X CPMI �lRCIAI G@NERAI IIARIIIh CLAWMAPR OOW.R AGP75 66 OT/OL/xO04 , I I, 07 01 005 10N OcalhltllNCE 1 1 RC W- A MVO FAP(AW MO PVW) I PERSONAL A ADv WURN s DENl.RAL aG0.NtGAT! 6 Z OFVL AGWEGAT9 pIA�#? APPJeO PSTt. X POLICY �!� t.00 PROOPCY$•OOMP/OPA� ® 2 A l APTOagtlAUAanm 75Z1106606i 47/01/1004 O7/02/2 5 cwAARaggsNCLr.LIMrr X ANr A.1iC f17.xlwnl' N.I. PM490 AUTO$ I ) 1OO8.1f NJURY 6CNFAW.EC AQTOO I X 1441iPAVt01 I OOPIIY NJURY w..- )I NO.VOVVMD AJTGY f i rMOPARTr OAMA F (Pa F4d4.^t) s 1 I E E �..T.... $ OMA04 LMAMTY _- J..... AUTO OW T • RA Ar.CIOANT ANY AUTO I AUIC ONIAN ACC AOG ? 1 A RM46SM IRUR LALIAaurr X OCCUA CIAMS WOE PEOUCTIGLE R1TL�NtIOn 1 0752116"Od O7 O1 ZO04 i 07141112005 3ACIrOCWMN0F ABGRRPATF ; r-- -- 6 1 1 $ 1 wOmQR/ MOePENRATM AMR lEMLOTRNR' NAGI ITr M PRO Ei (PLEV 6CVTNIt I O P1 t �.�. EaCM ACCIPRNr I v_ v1swe- SA WkOYB _ _ I ! E .....-- act: Tennis Court L1911tin4 at Clty Park ifIcate Holder is nwmd as an Additkonal Insured under the General Liability ONLY with respects to above referenced project. opt for 10 0axs Notice for Hon-payir�nt of Premium SHOULD ANT W TNA AW$1 WWRMV MLEM RR CANCRLLIP RRPOINTMI RVMTW DATA TMeRAar, TNP 4SUM Mi~ IeLA 1NP1&LV6R TO MA16 City of Fort Collins .".ice,. PAW Wmrr1N "No To T}MA oRMNIoAm MOLDIER VAMP TO re LEFT, Attn: John Stephen RUT FAAURR TO NNL WCH NOTME OVAL nMK NO PIIUOATIDN PR LIAM" PIC. fox 580 Of ANY M" UPON TMR MLEWL ITE A*1M4= WN1l1NtATIWN. Fort Collins, 00 $0522 AMC .10 tNLRMKtA+M �7.e-d.,I, Robert 5 be CIC ELIA w ACORP 28 9091INs) 0"OR0 COR!"AMN id88 12/22/2004 08:01 3034509648 �1� C R ELECTRIC PAGE 02 V ,.w T1P�tIn .�. _w'. - N,YJ.I Mv; al. 1 wn,u. __', wr . r. `. r 11 riwvri,4wr r .... w� - _.-.,.. � ..... . ._ . .. . -. .. ACOR_D. CERTIFICATE OF LIABILITY INSURANCE caR or 'A"LL10 cantiL-1 12 21 4 PRoI xaft THIS CERTIFICATE 1E ISSUED ASA MATT —Ph OF INFORMATION COWIE* / tuauraIICb Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Olson fi Olson Division HOLDER. THIS CERTIFICATE DOE$190T AMEND, EXTEND ON P. 0, Box L407 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. -- Inglewood CO E0150 - --- -^T Phone: 903-761-0095 Fax=3D3-7a8-1s17 INSURERS AFFORDING COVERAGE INAICa Pinnocol Assurance I �.FiEFf C A R 1116ctrical Contraotors �F_------------- ,-_----..--------.—L-.,_•------_- P.O. box 33440 Narthglenu, CO 20233 Fir.. RIP_ 4—'--------..__.--_--'--- _-_t_--.----^ E.i?Fei;:'P,.+.�gFll�'Ei!F'U.rJY:P•Ff£X'.15J 4O TD.w'-INTI n•+P.pN"'MEf'•P6('•:E. y'1G T-ET}.I; ''l'FklOr.' P6?�N.tpp prti*Wn NL'e•.9gf•° 1-. TdRM'^•' �::Fi:'L;.. i'!iK :w,' . b'e{:',;.' ,1B rJ MER C O'1VI/EIIT ', J! -N R'.ire 1;1 T) Vv41CM .l1IH CGHIif IrF, E v.r: 9F. rrjUL'P':N I w rN�aEf?-AIN FHA iISi1RRNiX AFP(Ik::E 1' ? -1r Prk CIEE ?E£a�R19F711?RFCa IA 3t E:JF.;-�6 A:, rFk. T9kbIS, ENf'! LFIpN; ANrI';gIOrtION° Y S! C!t ,o.p}P -n•TE , IN•115 5-IIWN Wo : V'•: &7EN Ftt%,,XD 91 F'.4 D CL�' IS .fir..._.__..-...-.. .. .... POLICY NUMBER LTR MIMD TYPE DF trA% AWE - IepC LIIWTB DA1' OM' DATE MWPO".II 68NEAAL LIABIMY I I Err,,, Cry!. T=FNC{ S � 'iCl :Hol -..._. _.... .. i`SyP?Kay L,..NnIiRCIAI LIAtlILnY J ELAN,"IS EllXi:r -NCt4tit) Ea.'ITre-:'_.___. !.L•;"*�f�;F` ( NEC; FAO] ft, 41:r Ryril;O 9 S._--_... i I vLk3JIWL 4 YiJ 111-cq .,.I C'T'EkJ0. I-=-._.�...,.....,�------'-- ~1:'REGATE L IMITAPP-4G Pr'a PFon.lc*�-r,-clls•.oF'x.0 _ !w"F:'MOMI! LIABBITY I I (a.,NV iEIJ S"d;LE INIT Ae5 I (E-1 cd,*rt) 3 b�Y:CA.tEGW car jYll'I'; 1 I, Fco A_:n I I'7iYidM1M+EU W1'Oj ! I rF'n ek yyLl'D -_ r'R'nrE a7'Y DmiI L:E- ! T � Ir efL.9Y:1 ' 1' --rt—.•�•..- �DARAC! LMAim ! A.'rI u'.I'• . FA ArX0Er.T a l i•N - 0 IJINEk i-AN EAMM '�... ......._ ._ ...._ I Al . umBiwORELLA LIAMIUTI EAC4 G='a�RTE',i.E { I lX:^LIk CLwN3 ]{oLE I I PAu4ECc4: F. 1 IMF ATE WORKERS COMPMUT4W AM x it 10%04RS•W&ILm 1 A I4058292 07/01/04 Ol/O1/08IP.I _ - _.. .-.__.._......-__... FH''tAL':'.OF, 7 ..n.A;.'Rlenr.=.IA:rErxe'ti:•:' _ �t100000n-__ Ei.GrAF'-mc_lI%100000 oFF!�Fti'IAEI.FEosx"I.u:'A.C' 101SST>CR9 SNG2S1DiD S ...I...... F-.w3....-._..._-'__ .1F'C-'IA, r+P4VI-IjN3 ON EL G�SF.".S. WA i`•-w.T I 00000 j-, oTNI� � - -umv Eas 39 MATT ww I MORRAIMM Of PR � ,- '7ESCIWPTI:M OF U r6rZATg1A IY6HKW9I EWWWONS ADDED BY IMDDR6EN6NTI SPECIAL PROVItON4 Waiver Of Subrogation applies in favor Of the City Of Fort C011JAS CERTIFICATE HOLDER CANCELLATION Cy>rTCOL SKI)LD AM/ OF nE ABOVE Q10CFWEO AOLMS BE CANCELLED SeFORS THE UPRA71ON DATE VAOF, Slit.*VLWQ'NSUAER"LL ENDEAVOR TOW& 230 DAYS wARIYTEN City of Et. Collins NOTICE TO n..E CEFW!CATE HOLDER NAMED TO TK LEFT, BIT FAILURE TO DO SO STALL Attn: John Stephen P.O. Box 590 IMPOSE NO OBLIGATICN OR LIABILITY OF ANY MIND UPON THE INSURER, RS ACBI-B OR tort Collins CO 60522 REPRESEFTfATIVES.- -'^_— 'A ENrATA'F AdORD2512001MR) T - OACORDCORPORATION 1988