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HomeMy WebLinkAboutINNOVATIVE ELECTRICAL SYSTEMS - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE 1/25/201�"""' 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 Van Gilder Insurance Corp. 1515 Wynkoop, Suite 200 Denver CO 80202 CONTACT NAME: Dawn Gaba an PHONE FAX _(AIC,No,EXtr303_83 40 a( c.NeL3_03 5 E-MAIL ADDRESS: dgabayan@V 1C. COm PRODUCER CUSTOMER ID #: INNELE INSURERS) AFFORDING COVERAGE NA_I_C_# INSURED Innovative Electrical Systems 7550 W Yale Ave., Suite B130 INSURER A: Hartford Insurance Company 0 INSURER B: Hartford Insurance (Service Ce 0 INSURERC:XL Specialty Insurance Co. 37885 Denver CO 80227 INSURER D : INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: 813837184 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 LT R TYPE OF INSURANCE ADDL'SIJBR INSR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A GENERAL LIABILITY 34SBWLN3274 1/22/2011 1/22/2012 EACH OCCURRENCE $1, 000,000 MMERCIAL GENERAL LIABILITY GE T�IV DAMATED PREMISES {Ea occurrenceZ_ $300, 000 MED EXP (Any one person) $10, 000 N71 CLAIMS -MADE 1.7 OCCUR PERSONAL 8 ADV INJURY $1, 000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 POLICY X PRO LOC $ A AUTOMOBILE LIABILITY 34SBWLN3274 1/22/2011 1/22/2012 COMBINED SINGLE LIMIT (Ea accident) $1, 000, 000 ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ X SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ X NON -OWNED AUTOS $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MP.DE AGGREGATE $ DEDUCTIBLE $ i Is RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N / A j 34WEGKE5825 1/22/2011 1/22/2012 X fVC STATUS JOTH- TORY LIMITS , ER_ $1, 000, 000 E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE $1, 000, 000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1, 000, 000 C Professional Liability Claims Made 539815 1/22/2011 1/22/2012 Per Claim $1,000, 000 Annual Aggregate $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) If required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and Owner are included as Additional Insureds for ongoing and completed operations under General Liability and Automobile Liability See Attached... ♦ "F%r lvl.r r� nvwr=rc 9,/114t.CLLA 1 IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City of Fort Collins c/o Aller-Lingle-Massey Architects P.C. P.O. BOX 580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 U 19SB-2UU9 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: INNELE LOC #: .4C© ADDITIONAL REMARKS SCHEDULE AGENCY NAMED INSURED Van Gilder Insurance Corp. Innovative Electrical Systems 7550 W Yale Ave., Suite B130 POLICY NUMBER Denver CO 80227 CARRIER I NAIC CODE EFFECTIVE DATE: G1pill] ILei PG1MNRJ1 Y 1Z� THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE:CERTIFICATE OF LIABILITY INSURANCE Page 1 of 1 ly with respect to liability arising out of the Named Insured's work performed on behalf of the rtificate holder and owner. This insurance will apply on a primary, non-contributory basis. A Blanket iver of Subrogation applies for General Liability, Automobile Liability and Workers' Compensation. mited Contractual Liability is included. : Project: South Transit Center ditional Insured: The City of Fort Collins. AGOKU 101 (20UU/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD