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Home My WebLink About104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATEr� ACORD CERTIFICATE OF LIABILITY INSURANCE GREGOC3 DATE (MM/DD/YYYY) 06 15 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agcy-Johnstown 4848 Thompson Pkwy, Ste 200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone: 970-635-9400 Fax: 970-635-9401 INSURERS AFFORDING COVERAGE NAIC # INSURED - -` INSURER A: Mountain States Insurance Grp INSURER B: Pinnacol Assurance 41190 INSURER C: Gre Ory Electric11 Inc . 331� I . Lincoln AVe . Loveland CO 80538 INSURER D: INSURER E: rnVrQAnPq 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. LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY - EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurence) $300,000 A X X COMMERCIALGENERAL LIABILITY CPP0116141 10/01/08 10/61/09 NSD 9k� (.^,ry on¢ FerScn,;. .� 10 , 000, - .. PERSONAL &ADV. INJURY $1,00.0,000 X Blkt Al UND 247 X Blkt WaiverCG2404 GENERAL AGGREGATE $2,000,000 LIMITED POLLUTION GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , OO O , O O O POLICY X PRO LOC JECT A X AUTOMOBILE LIABILITY ANY AUTO ELAP0116141 10/01/08 10/01/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident)$ A A HIRED AUTOS NON -OWNED AUTOS - X PROPERTY DAMAGE (Per accident) ' $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 5 , 000 , 000 A X I OCCUR CLAIMSMADE UNBOJI6141 10/01/08 10/01/09 AGGREGATE $ 5, 000, 000 $ - $ - DEDUCTIBLE - - $ X RETENTION $ 10 , 000 WORKERS COMPENSATION AND X TORY LIMITS ER B EMPLOYERS' LIABILITY ,ANY PROPRIFTOR/PgRTNFR/FXEC(,IT1YF OFFiCERiMEMBER EXCLUDED? 4014736 _ 07/01/09 07/01/10 E.L. EACH ACCIDENT - E.L. DISEASE - EA EMPLOYEEj $ 1,000,000 - $ 1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE- POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: NACC Handball Court Project. Certificate holder, its officers, agents and employees are listed as Additional Insured respects the General and Auto Liability. CERTIFICATE HOLDER CANCELLATION CITYFTB I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATI( 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 City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P.O. BOX 580 REPRESENTATIVES. Fort Collins CO $0522 AUT I*AEJRESE)7AT IJ, A _ _ �v AID.. A. i ACORD 25 (2001/08) V AGUKU GUKF°UKAI IUN 1ySS 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) Additional insured status applies if required by written contract or written agreement subject to the policy terms, conditions, limitations and exclusions. 10 days written notice of cancellation for non-payment of premium. ti 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)