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HomeMy WebLinkAbout350732 STURGEON ELECTRIC - INSURANCE CERTIFICATE03/01/05 ConfirmNet -> 13032276960 Pg 2/3 ACORD. CERTIFICATE OF LIABILITY INSURANCE 1 DATE 03/01 /ODIYYYY) l/OS PRODUCER 1-630-773-3800 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher a Co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Two Pierce Place ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Itasca, IL 60143 Michele Moore 630-285-3931 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA;Athena Assur Cc (A XV) 41769 Sturgeon Electric Company, Inc. INSURERB'. Zurich American Ins Cc (A XV) 16535 12150 E. 112th Avenue INSURERC'. Henderson, CO 00640 DOVhKAGE5 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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' POLICYNUMBER POLICY EFFECTIVE DATEtMMIDDIYYI POLICY EXPIRATION DATE(MMMDIYYILIMITS 09/30/05 B GENERAL LIABILITY GLOB37415410 09/30/04 EACH OCCURRENCE $2,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OOCCUR PREMISESEa wcurence $100,000 MEDEXP(Anywepersun) $5, 000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOPAGG $4,000,000 PRO LOC X POLICY F E IS AUTOMOBILE LIABILITY ANY AUTO RAPS37415508 (A/O/S) TAP83741560B (TX) 09/30/04 09 /30 /04 09/30/05 09 /30 /OS COMBINED SINGLE LIMIT (EaacotleM) $a, 000, 000 BODILY INJURY (Pmpermn) $ ALL OWNED AUTOS SCHEDULEDAUTCS BODILY INJURY (Peractltlent) $ HIREDAULOS NON OWNED AUTOS X PD Comp Ded $100,000 X PRDAMAGE (Per acddI acdtlenr) $ PD Coll Ded $100,000 GARAGELIABILITY AUTOONLY-EAACCICENT $ OTHERTHAN EAACC $ ANY AUTO $ AUTO ONLY. AGG A EXCESSIUMBRELLA LIABILITY QK06800832 09/30/04 09/30/05 EACH OCCURRENCE $10,000,000 X OCCUR LJ CLAIMS MADE AGGREGATE $ 10, 000, 000 $ XIDEDUCTIBLE$ RETENTION $10,000 $ B WORKERS COMPENSATION AND WC837415208 (A/O/S) 09/30/04 09/30/05 X I WCSTATU- OTH- LIM B EMPLOYERS•LIABRITY ANY PROPRIETOR)PARTNER)EXECUTIVE INCL WC837415108 (CA) 09/30/04 09/30/05 EL EACHACCIDENT $1,000,000 E.L. DISEASE-EAEMPLOYEE $1,000,000 B OFFICERIVEMBER EXCLUDED? EXCLWC837415308 Ifyes, tlesoMe under SPECIAL PROVISIONS below (WI/OR) 09/30/04 09/30/05 E.L. DISEASE - POLICY LIMIT 1 $1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Description of Job: SECO Sob No. 021536 - Replace 8• & 12• LED's from Traffic Signal heads at various locations determined by the City of Fort Collins Traffic Operations Department City of Fort Collins, Colorado is shown as an additional insured solely with respect to general liability and automobile liability coverage as evidenced herein as required by written contract with respect to work performed by the named insured. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1556 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN City of Fort Collins, Colorado NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL JO5II Stephen P.O. Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. REPRESENTATIVES. Fort Collins, CO 80522 USA AUTHORIZED REPRESENTATNE �n ACORD 25 (2001/08) michelel llD�� ©ACORD CORPORATION 79RA Powered ByCertiiicafesNowns 03/01/05 ConfirmNet -> 13032276960 Pg 3/3 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or after the coverage afforded by the policies listed thereon. Pz3&rIT17S►rT:7r 03/01/05 ConfirmNet -> 13032276960 Pg 2/2 ACORD CERTIFICATE OF PROPERTY INSURANCE DATE CERTIFICATE 03/01/0Ol/OS PRODUCER 1-630-773-3800 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher & Co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Two Pierce Place COMPANIES AFFORDING COVERAGE Itasca, IL 60143 COMPANY Michele Moore 630-285-3931 A Ace Prop & Cas Ins Co (A XV) INSURED COMPANY Sturgeon Electric Company, Inc. B 12150 E. 112th Avenue COMPANY C Henderson, CO 80640 COMPANY D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO 1 HE 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. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDD/YYI POLICY EXPIRATION DATE (MMIDD/YYI COVERED PROPERTY LIMITS PROPERTY BUILDING $ § CAUSES OF LOSS PERSONAL PROPERTY BASIC BUSINESS INCOME $ BROAD EXTRA EXPENSE $ SPECIAL BLANKET BUILDING EARTHQUAKE BLANKET PERS PROP $ FLOOD BLANKET BLDG & PP $ $ A X INLAND MARINE D35938485 09 /30/04 09/30/05 X See Below $ 2,500,000 $100,000 TYPE OF POLICY X Deductible Property Floater $ CAUSES OF LOSS $ NAMED PERILS X OTHER All Risk $ CRIME a TYPE OF POLICY $ BOILER & MACHINERY $ OTHER $ LOCATION OF PREMISESIDESCRIPTION OF PROPERTY SPECIAL CONDITIONSIOTHER COVERAGES Covered Property - Materials of Others in the Care, Custody and Control of the Named Insured Description of Job: SECO Sob No. 821536 - Replace 8• & 12- LED's from Traffic Signal heads at various locations determined by the City of Fort Collins Traffic Operations Department CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRISED POLICIES BE CANCELLED BEFORE THE 1556 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL City of Fort Collins, Colorado 30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: John Stephen BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P.O. Box 580 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE - Fort Collins, CO 80522 USA ACORD 24 (1195) mi,helel 0 ACORD CORPORATION 1995