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HomeMy WebLinkAbout263373 ELECTRONIC SYSTEMS - INSURANCE CERTIFICATEOP ID: SG .44c"mix CERTIFICATE OF LIABILITY INSURANCE (MM/DDIYYYY) 712/30/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW., THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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). PRODUCER 719-590-9990 Six & Geving Insurance, Inc. 719-590-9992 3630 Sinton Road,•Suite 200 . Colorado Springs, CO 80907-5034 Randy Geving CONTACT NAME: Suzanne Storm PHO .,CNo Ext:719-867-4502 FAX No: 719-590-9992 E-MAIL six-geving.com PRODUCE'Rsstorm CUSTOMER ID #: ELECT-1 INSURER(S) AFFORDING COVERAGE NAIC # INSURED Electronic Systems International, Inc. - 3010 Mallard Drive Colorado Springs, CO 80910-2247 INSURER A: First Mercury Insurance Co INSURER B: Pinnacol Assurance 41190 INSURER C : Acuity 14184 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MMIDD/YPOLICY E YYY MM DD/YYYY LIMITS ' A - GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR - PENDING ' 01/01/11 01/01/12 - EACH OCCURRENCE $ 1,000,000 DAMAPREMISGE ES Ea TO RENTEDoccurrence $ 50,006 MED EXP(Any one person) $ 5,000 PERSONAL & ADV INJURY -$ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ C - AUTOMOBILE LIABILITY ANYAUTOL75688 ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS - 01/01/11 01/01/12 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) - If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4076606 01/01/11 01/01/12 X WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CITYF-2 City of Ft. Collins Director of Purchasing and Risk Management P.O. Box 580 Ft. Collins, CO 80522-0580 LOYA101"4g1W1\INJ►1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD