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Home My WebLink About104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATE (2)2 I® CERTIFICATE OF LIABILITY INSURANCE OF ID RC GREGO-3 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agcy-Johnstown HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy, Ste 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 (INSURERS AFFORDING COVERAGE :NAIL# INSURED INSURER A: mountain States Insurance Grp INSURERS: P.innacol Assurance 41190 Greggor Electrict Inc. 3317 w INSURERC Lincoln Ave. INSURERD Loveland CO 80538 INSURERE: 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 AD6L - POLICY EFFECTIVE - POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MMIDD/YVVVI DATE(MMIDDM LIMITS GENERAL LIABILITY EACH OCCURRENCE '.,$1,000,000 A X X COMMERCIAL GENERAL LIABILITY CPP0116141 10/01/09 10/01/10 ' DAMAGE TO RENTED PREMISES (Ea occurence) $ 300,000 'CLAIMS MADE X OCCUR MED EXP(Any one person) $10,000 X Blkt Al UND 247 '.. PERSONAL BADVINJURY $1,000,000 X Blkt WaiverCG2404 LIMITED POLLUTION GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG $2,000,000 POLICY X ',I. JECT LOC _. AUTOMOBILE LIABILITY A '': X X ''.. ANY AUTO : BAP0116141 '!. 10/01/09 10/01/10 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000 OQQ r ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS ": (Per person) A X HIRED AUTOS BODILY INJURY $ A .. X NON -OWNED AUTOS (Per accident) --- --- : PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY ' (AUTO ONLY - EA ACCIDENT ".$ ',. ANY AUTO ,.. ' _ _.. OTHER THAN EA ACC .. $ '., AUTO ONLY AGG $ EXCESS UMBRELLA LIABILITY '', EACH OCCURRENCE I$5,000,000 A ! X '.00CUR . CLAIMS MADE ,. IJMB0116141 10/01/09 '. 10/01/10 AGGREGATE $ 5,000,000 ''. DEDUCTIBLE X ': RETENTION $10 , 000 $ ..... WORKERS COMPENSATION AND EMPLOYERS' LIABILITY X TORY LIMITS ER YIN B IANYPROPRIETOR/PARTNER/EXECUTIV : 4014736 Q7/O1/O9', O7/O1/1O O EL EACH ACCIDENT $l,000 QQO nrlatorycr�paR Vln6mRNHE) R FXCI HOED? (Ma - ' It es, describe under : :r E.L.ISEASE EA EMPLOYEE $ 1 000 000 r SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 , 000 , 000 OTHER DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES I EXCLUSIONS ADDED BV ENDORSEMENT/ SPECIAL PROVISIONS RE: NACC Handball Court Project. (See holder notes) UAINGLLLA I LVN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI CITYFTB 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 City of Fort Collins REPRESENTATIVES. P.O. BOX 580 AUTHORIZ REPRESENTATIVE Fort Collins CO 80522 ACORD 25 (2009/01) ION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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. If required by written contract or written agreement the provisions apply subject to the policy terms, conditions, exclusions: Certificate holder, its officers, agents and employees are included as Additional Insured for ongoing and completed operations under General Liability 10 days written notice of cancellation for non-payment of following limitations and Exception: premium. 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.