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Home My WebLink AboutJBI ELECTRICAL SYSTEMS - INSURANCE CERTIFICATE (2)ACORDt, CERTIFICATE OF LIABILITY INSURANCE DATE I 1 12130104 l30l04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Wm. Rigg Co. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 777 Main St, Suite C-50 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ft. Worth. TX 76102-5333 817-820-8100 INSURERS AFFORDING COVERAGE INSURED JBI Electrical Systems, Inc. INSURER A: Arnerlsure Mutual Ins Co INSURER B: Annerisure Mutual Ins Co JDM Electrical Inc 5705 Azle Ave INSURER C: Fort Worth TX 76114-1120 INSURER D: INSURER E: COVERAGES 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVDATE E POLICY EXPIRATIONAJJL LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR CPP2056710-04 Blanket waiver of Subrogation Blkt Additional Insured applies if required by Written Contract 1/01/05 1/01/06 EACH OCCURRENCE S 1000000 FIRE DAMAGE (Any one fire) $ 50000 MED EXP (Any one per5onl $ 5000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY X PO- JECT LOC PRODUCTS - COMP/OP AGG $ 2000000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CA20065540-04 Blanket Waiver of subrogation.Blkt Additional Ins. applies if required by Written contract 1 /01 /05 1 /01106 COMBINED SINGLE LIMIT (Ea accident) $ 1000000 X BODILY INJURY (Per Person) S X BODILY INJURY (Per accident) S X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS LIABILITY X OCCUR CLAWS MADE DEDUCTIBLE X RETENTION $ 10000 CU2005674-04 1 /01 /05 1 /01106 EACH OCCURRENCE $ 5000000 AGGREGATE $ 5000000 S $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY W C2005244-04 Blanket Waiver of Subrogation. Blkt Additional Ins if 01 /01105 required 01101 /06 Wrlt.con X OI RY M TS OER E.L. EACH ACCIDENT $ 500000 E.L. DISEASE - EA EMPLOYEE $ 500000 E.L. DISEASE - POLICY LIMIT S 500000 A OTHER LEASED OR RENTED EQUIPMENT IM2005673000 1/01105 1101/06 100,000 DEDUCTIBLE 1,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS LICENSE #5510 MASTER LICENSE-LUNSFORD #26496 CERTIFICATE HOLDER ADDITIONAL INSURED: INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION FORT COLLINS, COLORADO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN PO BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL FORT COLLINS CO 80522-0580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPP TATIVEI� AGORD 25-5 (7/97) / ® ACORD CORPORATION 1988