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Home My WebLink AboutELECTRONIC SYSTEMS - INSURANCE CERTIFICATECORD,. CERTIFICATE OF LIABILITY INSURANCE OP ID SG DATE(MMIDD/YYYY) ELECT-1 12/19/OS PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Six & Geving Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 3630 Sinton Road, Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. jColorado Springs CO 80907-5034 Phone:719-590-9990 Fax:719-590-9992 INSURERS AFFORDING COVERAGE NAIC# INSURER A._pevn-scar xnsucanco comnaaY Electronic Systems INSURERS: Pinnacol Assurance 41190 International, Inc. INSURER C: 3010 Mallard Drive ---- ---- ---- ------ Colorado Springs CO 80910-2247 INSURER D: rnVFRAr:FC 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. PbIL-1 MMIDD/YY PDA E EXPIRATION ---"—"—"---""" LTft NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/VY DATE MMIDD/YY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY MAOE 41 OCCUR PAC6794915 01/01/09 01/01/10 URRENCE$2000000A OTtENTBT3'--"- occurence) X --- $ 100000 ny one person) _CLAIMS $5000 S ADV INJURY =AGGREGA2 $2000000GGREGATE $ 2000000GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECTLOC._—__ -COMP/OP AGG $20000001 _.—._---"—_.. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUi'OS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS -------"---- COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ .. BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANYAUTO--------- AUTO ONLY - EA ACCIDENT $ OTHER EA ACC AUTO ONLY: AGO $ $ ---_-- EXCESS/UMBRELLA LIABILITY 1 OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ ------- -- '-- E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER'MFMBER EXCI.UDPD4 If yes, describe under SPECIAL PROVISIONS below OTHER 4076606 01/01/09 01/01/10 7C TORV LIMITS ER E.L. EACH ACCIDENT — --- $100000 --- EL. DISEASE - EA EMPLOYEE ----__— $ 100000 E.L. DISEASE -POLICY LIMIT $ 5 0 0 0 0 0 DESCRIPTION OF OPERATIONS I FLOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS rc RTIciCATc Una nco City of Ft. Collins Director of Purchasing and Risk Management P.O. Box 580 Ft. Collins CO 80522-0580 CITYF-2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 REPRESENTATIVES. AUT,46,01ZED R€PR[SENT'ATIVE . 25 (2001/08) GL•T:il 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.