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Home My WebLink AboutC R RLECTRICAL - INSURANCE CERTIFICATEACORP. CERTIFICATE OF LIABILITY INSURANCE CSR DP DATE(MMIDDIYYYY) C&REL-1 12 21 04 PRODUCER Compass Insurance Agency, Inc. Olson & Olson Division THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 1467 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Englewood CO 80150 Phone:303-761-0085 Fax:303-788-1817 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA: Pinnacol Assurance INSURER B: C & R Electrical Contractors P.O. Box 33448 Northglenn, CO 80233 INSURER C: NSURER D: INSURER E' 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. N5N LTR NSR TYPE OF INSURANCE POLICY NUMBER -EFFECTIVE DATE MM/DD/YY OLICY EXPIRATION DATE (MM/DD'YYL LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ CLAIMS MADE E OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 17 POLICY PROJECT LOC AUTOMOBILE LIABILITY INGLE LIMIT $ ANY AUTO c (Ea acl ident) ALL OWNED AUTOS � BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EAACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND X TO CY LIMITS ER A EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 4058262 07/01/04 07/01/05 E.L. EACH ACCIDENT $100000 OFFICERIMEMBER EXCLUDED? OWNERS INCLUDED E.L. DISEASE- EA EMPLOYEE$100000 If yes, describe under E.L. DISEASE -POLICY LIMIT $500000 SPECIAL PROVISIONS below OTHER -EXCEPT FOR 10 DAYS FOR NONPAYMENT OF PREMZ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Waiver of Subrogation applies in favor of the City of Fort Collins vu�iitwn nW�UQM CAMCFI1 ATInM CYFTCOL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL * 30 DAYS WRITTEN City of Ft. Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn: John Stephen P.O. BOX 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Fort Collins CO 80522 REPRESENTATIVES. ACORD 25 (2001108) 1 © ACl coRPnRATInM 1 QAR ACORDM CERTIFICATE OF LIABILITY INSURANCE 12/21/2 0 ' PRODUCER (303) 756-9909 FAX (303) 7S6-8818 Keller -Lowry Insurance Inc 1777 S Harrison St #700 Denver, CO 80210 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED C & R Electrical Contractors, Inc. P.O. Box 33448 Northglenn, CO 80233 INSURERA: Allied Group/Nationwide Mutual INSURER B: INSURER C: INSURER D: INSURER E: CnVFRAr,FS 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY ACP7521106606 07/01/2004 07/01/200S EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100, DD CLAIMS MADE O OCCUR MED EXP (Any one person) $ 5,00( A PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00( X POLICY JE LOC AUTOMOBILE LIABILITY ANY AUTO ACP7521106606 07/01/2004 07/01/200S COMBINED SINGLE LIMIT (Ea accident) $ 1, 000 , 00 X BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESWUMBRELLA LIABILITY ACP7S21106606 07/01/2004 07/01/2005 EACH OCCURRENCE $ 1,000,00 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 A $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION ANDYIIMWC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES ! EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Project- Tennis Court Lighting at City Park Certificate Holder is named as an Additional Insured under the General Liability ONLY with respects to he above referenced project. Except for 10 Days Notice for Non -Payment of Premium City of Fort Collins Attn: John Stephen P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Sibelius, CIC/CELIA ACORD 25 (2001/08) ©ACORD CORPORATION 1988 12/22/2004 08:01 3034509648 C R ELECTRIC PAGE 03 KELLER LOWRY INS INC Su3I700010 Icrcl vT It .1/ - RATE ReAINJFY m . CERTIFICATE OF LIABILITY INSURANCE la/I1/zoo4 Keller -Lawry Insurance Inc 1777 5 Harrison St #?%I Denver, CO $0210 D P.O. soot 33446 Northglenn, CO som IN$uRERS AFFORDING COVERAGE INIWOO A; NATO / THE DO:.ICIES 00 INSURANCE U87I115 BILOW HAUL aE9N ISSUED T57HE IMMURED HAMED A90VE FOR THE POLICY P[RIOD IN61eAT*11 N07WRHSTAND'Na ANY REOVIREMENT. TERM OR CONDITION OF ANY 024WT OR OTHER DOCUMENT WITH REAPECT TO wHICH THIS CERTIF CA_r1 MAY ea ISSUED OA MAY PMTAIH. TFE INSVRAD,APPOPOW MY THE POLICIES OasCRq= HsRVIN IS SUBJECT TO ALL 714E TERMS. EXCI.USIONS AND CONDITIONS OF BUCK POLICIES, A00RSOATE LIMIT'S PAC WN MAY HAVE 999NREDUCBD BY PAID CLAWS. M A TYPI MNImAMOE wMnou. twm rr X QP&MiRCIAL UKRAL JAR0.1rY CLAW MADE �OCCVR NIIYrE1T Y ACP7521106605 OT/Ol/20U4 0T 0i 005 ! �. LMPrI eAON ocamRSNCE @ 1 000 000 kED FA?(Ay OWOW01)� S 5,000 PERIDAAt A ADv MAY I 1 000_ . ppb ��— GENERAL hiOREOAT! 0 21900 a" OES'L ACDREOATB MIT APP.Ma PER X roucY 71 ,.nc PROOM s. Wmpfop ADO ® 2,000,000 A I i AUTOMOWLI LIANUM AU7521MG606107/01/1004 07/01/2DOS OOMINrjp BNFLF. LIMN' /@n Mkleynl' X ANrA.nc AN. DwuyO AU70I I 9001,Y ""Y ECHEOW.ED AIJTON ! iFarAdy011) I k 14 M OAVtof MOOu.Y wuar M. j . +Tk:f OEYMb1Ii X npN•OWNI'�A.ATO@ PROPRRfY OAMAV y ,IL000,0011 y r• E _.� y GAAAM 1."LIfY -��^- AUTO OmY. FA AMIDW? ANY ANC OTNgR 71-Mt EA ACC AUTO ONLY AfyO y � I I A WKwNsruNem"PIAM rY X OOWUA a.NI.410%. RETEktmw I 07521106606 07 01 2004 i 07 Ol/t 05 SACrOCCL"MNCE I ApPROAfE � r_—.._..... a 1.0001000 1,000 0 �-- I ENORIDER roOMI1A�ENMTION NO I ANY PfWppR�tI(iTOP�t��qARTNAIVF�IIOV � IYI oMF�fK� RAGMKARI�LUDED7 906MMO • �av, Tl& I iNg L... euiCN ACCIDIIrr E.L. OISW+SE• EA QAITWYE U.. Oue,"I • POLICY LIMIT I I I y CTN[R am tKTT0N orOF" 71p1I rLOCA /YlMCLIII7: oONELMDlD 6Y INppRIIMMMT r>tVNCIAL PROMIiON3 roject, Tennis Court Lighting at C ty Park rtificate Holder is named as an Additional Insured under 'the General Liability ONLY with respects to he above referenced project. Except for 10 Days Notice for Non-Pay"J"It of Premium IHMLO ANY OF TM AVM OIICRRED POIICIn II OANCRLLED I IFORI THE EXPIRATM DATI T!aINIOP. TN4ISIURFO INWRRR YALL @NDII TO MML City of Fort Collins "' DAY@Witi"sN NDTIcE rD YHE OM. No{oIR NAMED ro THI LGFY, Attn : John Stephen MOT FAauft TO NAd, WCH ROME WALL P POK 40 0101416ATN)N OR W ILA /,0. 11" Sao Of AW MOUPON THE MKIMIA.IP@AMERTsaRREPRgMWATIV". Fort Collins, 00 $0522 LUTNOM MRIPREI[a 4" RdMbert 5 be CIC CELIA �r AGL7Rp Z5 (ZODfIDa) GAGORG GORPORATTON 7Yaa 12/22/2004 08:01 3034509648 C R ELECTRIC PAGE 02 ,Ivr u. w.,,wo rq„v,.n n.. ..nyV,Ir�n and Ywn w,.�, rwnn.. v,wvrl w, ...ro.nr .inn ,v.ewr•rrwrr,i.wl yv...�w�.�.� �..,,,. �.�.....-. .. _. .. .�_ .. ACOLD. CERTIFICATE OF LIABILITY INSURANCE caR DP °A I�°^� CSARtr-1 18 21 04 PRDDIICPR TNI9 CERTIFICATE Ia ISSUED AS A MATTE OF INFORMATION Cams Insurance Agancy, Inc. ONLY AND CONFERS NO RIDHTS UPON THE CERTIFICATE Olson E Olson Division HOLOER. THIS CUM14 :ATE DOES NOT AMEND, EXTEND OR P.O. Sox 1467 ALTER THE COVERAGE AFFORDED BY THE POLICIES E6LOW. Laglewood Co 60150 ___�"""-'--r — Phone:303-761-0085 re%_3D3-78a-1a17 INSURERSAFFORDINGCOVERACE INAIC� INSUmG- ... _...._..... _.._.___....__—...... __............ ............ Pinnacol Assurance C i A llactrical Contreetors "' ��" L_------- x 83448 CO Northglenn, CO 80233_.._--.�-----•--- THi':L:,^IE.i'?Fw;.V,.4\Gf IR'Ei.•F°Ir?JMq\F 9EE.19?I:Eo 7" H'-INFI IASOIj^M?:oA&L-•:F'V.�PT-FPA. I:"PER ('n rrta'n•.r}O hGrWn .3T'..'•u>i•r.) W.kk.'a•1REFS+J-. T2NM"m'.L?�•I;b:P7(%Ih'.:a{:n;.'I,Jk'JMER C4'.V4'E11T';J!-H F4tlFf.,;l r1W41CM .TIIH CEHIP KA Ev,.!BE MA. PER'AIN Try! NJ )RAWZ/-PF!q]F:?y TrF P•,kOF-,:Q9']A10EON?RFI'J IE 3l b,IF.:-rUA:_rro,T?.-PNIS,E!GLLFI•)Np JN(•Ii grbITION'y SLfM A-*117E JW$'.,tiJWN IAA)':P`•c ??-TEN A[.CLnSb 9'I F.A C`CLAJ'15' ".. 11011 ff;CV I ., ... ....._...... ...----.. ... OR NMk TfME DF WOL RMICE POLICY NtrMBER DA7 MM,DOFry DATE O'YY1 ' LIASTA GENERAL LIABILITY — �C":MMji?G:IAI 'i<''kHOL LIAtlf.'IY I I EaT,S'rYl_y� � ::j7-,:LAW1"1E I!A...i.r' j 4 = ,+gC6ML,L8 CO GAG iklw (=r l,.own T J•••�__._— _ _ 1 I YLR351W: Y ^iiJ fIJ.AI s.— '-[r'ERAL A[ cNI J"Y:'REi+AiE41 iR APA!,,EG - H:- [},IC PKG'rc,,.,; iIIrF',rlA' AL4 :T }I POLICY I ,E;I 1' AA{Y;'M0KE UASUTY 1 ' � � G:.eHI•fEC �'La_ UNIT >r: • ALiO I i IE'J a".rbwcq E i `IJ' `:=CtllEf,.wl :v3 i PYr F✓n:..i i7 L----..._..-� --.. _.._— 'TlI r7JN !nNJEU cIn'DS ! fL tr Lv;,a AJN'[I �- I --------..—.-..,.., I � i ' r>RnAEafe :+AI.I•LL` ' a 'N Of5.;1M!I I:AMC! LMB4ITY i ' N T/)1)'1'• .:r<FJ.LI:7F.r.' a - __ ' IJ1NEq T-AN CA wx y .. ...• anRABR0.LA LIABIL11r EAL;4,1rLIR7E42E IA JEX 7UR ._I I �.. .. ..___.__. —_._.I ..._..._..__._............., VVUN16RS CONMIMAT'CN AND X EWLOL'PLY LMAIMY A { 4058262 07/01/04 07/01/0E . A.I BL.�''+ac:I�,E•T a 300000 .cn .•K;HI:IE71ywF.,f:1'EP/El.dr_r J_ i,FA!'F('VAF,AREA FR^'.U:'E.i,I ONtRS INCLUDED _ 0o_0o0 ii yyY, rii Slit LA00 :NN .PP o�_. n0 EL CI9u:EAa"-C:•J+'T 7A - OTHER frcur 3aR 3T "TV eon --- 11� NONPJ1Ym" of PAIrLa m CEICWPTIONOF WWL31:AIq rVGiaBEIEKCLUD:GNEA00W BIND0116EN@I.TIBAECIAL PROVI>oNt Waiver of Subrogation applies in favor of the City of Fart Collins City Of rt. Collins lttn: John Stephen P.O. Box 500 rort Collins CO 80522 KL' CYrTCOL SHCULD ANV OF THE ABOVE OESCRIOW AOlM3 BE CANCELLED BEFORE THE E%PRTATION DATETkgHOF.THE.$W"5•NBVRERMILLENDMVORTONWL 230 OAYR MITTEN NOTICE TO TF.E CERTIF!CA7E HOOER NAM TO THE LEFT, B. • FAILURE TO DO 50 SMLL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE MEURER, ITS ACEN'R OR REPREBEWATTVES.