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131436 METRONINC - INSURANCE CERTIFICATE
ACORIZ CERTIFICATE OF LIABILITY INSURANCE i2122/2 04 PRODUCER (303)773-9999 FAX (303) 773-9776 Arthur J. Gallagher & Co. - Denver 6399 S. Fiddlers Green Circle Suite 200 Greenwood Village, CO 80111 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 TWP, LLC Metron, Inc. 150S West Third Avenue Denver, CO 80223-2811 INSURERA: Federal Insurance Company 010040 INSURERS: Lexington Insurance Company INSURER C: INSURER D: INSURER E: crr-Q 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 AM DD' INSRDATE TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE IMMIDDAM POLICY EXPIRATION DATE iMWDDIYYI LIMITS GENERAL LIABILITY 3S79-93-56 10/01/2004 10/01/2005 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDoccunanc,U $ 1,000,000 CLAIMS MADE a OCCUR MED EXP (Any one parson) $ 10,00( A X PERSONAL & ADV INJURY $ 1 1000 1 00 GENERAL AGGREGATE $ 2,000,00C GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X j CT LOC PRODUCTS - COMP/OP AGG $ Exclude AUTOMOBILE LIABILITY ANY AUTO 7499-21-84 10/01/2004 10/01/2005 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ A X ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY OCCUR ❑ CLAIMS MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND WC STATU- I OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT s B Pructs/Completed perations Liability 0328868 10/01/2004 10/01/2005 $1,000,000 Each Occurrence $2,000,000 Aggregate E50,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS he City of Fort Collins, its officers, agents and employees are shown to be additional insureds for General Liability only (excluding Products/ Completed Oper) and Automobile Liability s their interests may appear in work performed by the Named Insured. E: P-957 Old Town Square Plaza Renovation r1^A - .- --- City of Fort Collins Attn: James B. O'Neill II ACORD 25 (2001108) 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 LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Barnes/NEH��-M•p ©ACORD CORPOF 1989 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 alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) ACORD. CERTIFICATE OF LIABILITY INSURANCE DAD 11/08/08/2004) 004 PRODUCER (303) 773-9999 FAX (303) 773-9776 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J . Gallagher & Co. - Denver ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 6399 South Fiddler's Green Circle, Suite 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greenwood Village, CO 80111 Barbara Gum ext. 2606 INSURERS AFFORDING COVERAGE NAIC # INSURED TWP, LLC (See attached Named Insured list) INSURERA: Federal Insurance Company 010040 1SOS West Third Avenue INSURERS: National Union Fire Ins of Pa 020014 Denver, CO 80223-2811 INSURER C: INSURER 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. INSR ADIrL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMMOfM POLICY EXPIRATION DATE [MMIDnNY% 10/01/2005 LIMITS GENERALLIABILITY 3579-93-56 10/01/2004 EACH OCCURRENCE $ 11000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDre $ 1,000,00( CLAIMS MADE FX OCCUR '000,00 $ 10,00( MED EXP (Anyone person) A PERSONAL & ADV INJURY $ 1 000 00 GENERAL AGGREGATE 1 1 $ 2,000,00( GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ Exclude POLICY X JEC LOC AUTOMOBILE LIABILITY 74992184 10/01/2004 10/01/2005 ANY AUTO COMBINED SINGLE LIMIT $ X (Ea accident) 1,000,00 ALL OWNED AUTOS BODILY INJURY $ A SCHEDULED AUTOS (Par person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY BE 3207169 10/01/2004 10/01/2005 EACH OCCURRENCE $ 101000100 X OCCUR ❑ CLAIMS MADE AGGREGATE $ 10,000,00( B rod/Comp Oper $ 10,000,00 DEDUCTIBLE X RETENTION $ 10,00 $ WORKERS COMPENSATION AND WC STATU- I OTH- EMPLOYERS' LIABILITY TORY I IMITS -EEL E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ SPECIAL PROVISIONS below THER Coverage: 3579-93-S6 10/01/2004 10/01/200S Bld s & Pers Pro $7,582,S00 9 p: Aroperty ecial Form, repplacement Business Income: $3,100,000 Cost Blkt EDP: $275,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS he City of Fort Collins, its officers, agents and employees are shown to be Additional Insureds their interests may appear with respect to the General Liability and Automobiles coverages own above and any claims arising out of work performed by the Named Insured under the 1I00 llowing agreement RE: Rolland Moore Pumping Plant Renovation. verage references: GL - 80-02-2000 (4/01); Auto - CA2048. City of Fort Collins Attn: James O'Neill P.O. Box 580 Fort Collins, CO 8OS22 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 LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Barnes/NEH��-^-� AL,VKU ZO (ZUU9/U6) ©ACORD CORPORATION 1988 TWP, LLC (See attached Named Insured list) Addendum to Liability Certificate 11/08/2004 Arthur J. Gallagher & Co. - Denver 10/17/2003 Named Insureds DOMESTIC OPERATIONS: TWP, LLC Tecknit Shielding Systems, Inc. Tecknit Interconnection Products Tecknit, Inc. - New Jersey Tecknit EMI Shielding Products, Inc. Metron, Inc. INTERNATIONAL OPERATIONS: Tecknit De Mexico S.A. De C.V. Tecknit (Beijing) Electronic Technology Co., Ltd. Tecknit Europe Ltd. TWP Europe, Ltd. Tecknit Europe Espana, S.L. Tecknit (Suzhou) Electronics Co., Ltd. Young Electric Manufacturing