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Home My WebLink AboutSTURGEON ELECTRIC - INSURANCE CERTIFICATE (4)03/01/05 ConfirmNet -> 13032276960 Pg 2/2 ACORD CERTIFICATE OF PROPERTY INSURANCE DATE /0l/OS1/05 D/YY) PRODUCER Arthur J. Gallagher & Co. 1-630-773-3000 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. 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 COMPANY C 12150 E. 112th Avenue COMPANY Henderson, CO 80640 D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR I"HE 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 (MMIDDIYY) POLICY EXPIRATION DATE (MMIDDIYY) 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 X1 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 IS IX NAMED PERILS $ OTHER All Risk CRIME $ $ TYPE OF POLICY BOILER & MACHINERY $ $ OTHER $ LOCATION OF PREMISESMESCRIPTION OF PROPERTY SPECIAL CONDITIONNOTHER 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 DESCRIBED POLICIES BE CANCELLED BEFORE '[HE 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 P.O. Box 580 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE _. USA ACORD 24 (1/95) michelel 0 ACORD CORPORATION 1995 03/01/05 ConfirmNet -> 13032276960 Pg 2/3 ACORDCERTIFICATE OF LIABILITY INSURANCE 0MDO/YYYY) 3/Ol/OS 3/0� PRODUCER 1-630-773-3000 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 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 Co (A XV) 41769 Sturgeon Electric Company, Inc. INSURER e'. Zurich American Ins Co (A XV) 16535 12150 E. 112th Avenue INSURERC. Henderson, CO 80640 INSURERD'. 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 DD' MANCE POLICYNUMBER POLICYEFFECTIVE q /YyI POLICY EXPIRATION DATE(MMMDIYYI LIMITS B GENERAL LIABILITY GL0837415410 09/30/04 09/30/05 EACH OCCURRENCE $2,000,000 PREMISES aoccurence $100,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OOCCUR MEDEXP(Anyoneperson) $5,000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS -COMP/OPAGG $4,000,000 X POLICY 71 PRO- 71 LOC B B AUTOMOBILE X LIABILITY ANY AUTO BAPS37415508 (A/O/S) TAP837415608 (TX) 09/30/04 09/30/04 09/30/O5 09/30/05 COM81NE0 SINGLE LIMIT (Eaacddent) $2, 000, 000 BODILY INJURY (Per Person) $ ALL OWNED AUTOS SCHEOULEDAUTOS BODILY INJURY (Par accident) $ HIREDAUTOS NON -OWNED AUTOS PROPERTY DAMAGE (PeraccidenO $ X PD Comp Ded $100,000 X PD Coll Ded $100, 000 GARAGELIABILITY AUTCONLY-EAACCIDENT $ OTHERTHAN EAACC $ ANY AUTO $ AUTO ONLY', AGO A EXCESS/UMBRELLA LIABILITY QK06800832 09/30/04 09/30/05 EACH OCCURRENCE $10,000,000 X I OCCUR CLAIMS MADE AGGREGATE $ 10, 000, 000 $ HXDEDUCTIBLE $ RETENTION $10, 000 B WORKERS COMPENSATION AND WC837415208 (A/0/9) 09/30/04 09/30/OS TH- X WCSLIMTATU- DER B EMPLOYERS'LIABILITY ANY PROPRIETORRARTNEILEXECUTIVE INCL WC837415108 (CA) 09 /30 /04EL 09/30/05 EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 B OFFICER/MEMBER EXCLUDED? EXCLWC837415308 (WI/OR) 09/30/04 09/30/05 If yyes, describe under SPECIALPROVISIONSbebw I E.L. DISEASE -POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Description of Job: SECO Job No. 821536 - Replace 8• & 12° LED's from Traffic Signal heads at various locations determined by the City of Fort Collins Traffic Operations Department City of Fort Collins, Colorado is shown as an additional insured Solely with respect to general liability and automobile liability coverage as evidenced herein as required by written contract with respect to work performed by the named insured. CERTIFICATE Mr3I nF;R P.AMeFI I ATIAM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 1556 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN CS ty of Fort Coll ins , Colorado NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn: John Stephan P.O. Box 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 USA AL,UKU ZO tZUUTIUo) micaeiei V AULIKU UUKI'UKA 1 IUN T9t%i$ 2517362 Powered ByCertificatesNow"m 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. AGOKU Z5 tZ007/0al .03/01/05 ConfirmNet -> 13032276960 Pg 2/3 ACORDN CERTIFICATE OF LIABILITY INSURANCE DAT03Ol/OS/01/05/YYYY) 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 Two pierce Place ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# Itasca, IL 60143 Michele Moore 630-285-3931 INSURED INSURERA:Athena Aasur Co (A XV) 43.769 Sturgeon Electric Company, Inc. INSURERS Zurich American Ins Co (A XV) 16535 12150 E. 112th Avenue INSURER C. INSURER D', Henderson, CO 80640 INSURERE'. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTH E 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 0,1313% POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONTYP LIMITS B GENERAL LIABILITY GLOS37415410 09/30/04 09/30/05 EACH OCCURRENCE $2,000,000 PREMISES Ea pcmrence $100,000 X COMMERCIAL GENERAL LIABILITY CLAIMSMADE[11 OCCUR MEDEXP(Anyonepemw) $5,000 PERSONAL&ADV INJURY $ 2,000,000 GENERAL AGGREGATE $4,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOPAGG $4,000,000 -XI POLICY 7PRD LOC JE B AUTOMOBILE LIABILITY BAPS37415508 (A/O/S) 09/30/04 09/30/05 COMBINED SINGLE LIMIT B X ANYAUTO TAP837415608 (TX) 09/30/04 09/30/05 (Eaaccitlenq $2, 000,000 BODILY INJURY $ ALL OWNED AUTOS SCHEDULEDAUTOS (Per person) BODILY INJURY $ HIREDAUTOS NON -OWNED AUTOS (Per accident) X PD Comp Dad $100,000 PROPERTY DAMAGE $ I PD Coll Dad $100, 000 % (Peraccident) GARAGELIABILITY AUTO ONLY -EA ACCIDENT $ OTHER THAN EAACC $ ANYAUTO $ AUTOONLY: AGO A EXCESSIUMBRELLA LIABILITY QK06800832 09/30/04 09/30/05 EACHOCCURRENCE $10,000,000 X I OCCUR CLAIMS MADE AGGREGATE $ 10,000,000 $ $ DEDUCTIBLE $ X RETENTION $10,000 B WORKERS COMPENSATION AND WC837415208 (A/O/S) 09/30/04 09/30/05 % WCSTATU- GTH- B EMPLOYERS'LIABILITY WC837415108 (CA) 09 /30 /04 09/30 05 / EL EACH ACCIDENT 1,000,000 $ ANY PROPRIETORMARTNERIEXECUTIVE IN E.L. DISEASE - EA EMPLOYEE $1,000,000 B OFFICERIMEMBEREXCLUDED? EXCLWC837415308 (WI/OR) 09/30/04 09/30/05 Ityes desalt under E.L. DISEASE - POLICY LIMB $1,000,000 SPECIAL PROVISIONS heIDW OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Description of Job: SECO Job No. 821536 - Replace 8• a 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. 556 Lty of Fort Collins, Colorado ttn: John Stephen .0. Box 580 Collins, CO 80522 ACORD 25 (20011081 michelel 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE n �r USA I 2517362 PDWered ByCertificafesNow'"I 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.