Loading...
HomeMy WebLinkAbout104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATE (4)UP It): KU ACORO° CERTIFICATE OF LIABILITY INSURANCE DATE06/17DIYrrr)--- sn n11 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 endorsements . PRODUCER 970-635-9400 CONTACT NAME: 4PFS84 Insurance Group - JT 4648 Thompson Pkwy, Ste 200 970-635-9401 Johnstown, CO 80534 John Hintzman-ADDRESS: PHONE FAX (ALC, Ne, EXW INC,No): E-MAIL PRODUCER GREGO-3 _CUSTOMER ID a: INSURER(S) AFFORDING COVERAGE NAICN INSURED Gregory Electric, Inc. INSURERA:Travelers Companies INSURERS: Pinnacol Assurance 41190 3317 N. Lincoln Ave. Loveland, CO 80538 INSURER C 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. CY EFF MhVDDYYVYY LIMITS INTR TYPE OF INSURANCE ADOLTISUBRmo I POLICY NUMBER ,POLIEXP A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS4)IADE a OCCUR X Blanket Add'I ins C09741IR371 LIMITED POLLUTION 10,01110 10,01/11 EACH OCCURRENCE DAMAGE TO RENTED PREMISES E. occurrence) $ 1,000,00 $ 3BB,DD MED EXP(Any one person) $ 1B,BB PERSONALS ADV INJURY $ 1,000,000 X Blkt Waiver GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER'. RO n LOC POLICY FT PFrT PRODUCTS - COMPIOP AGG $ 2,000,000 $ A A A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA9748R372 BLANKET ADD'L INS. BLANKET WAIVER 10/01/10 10/01/11 CO BINEDi&NGLE LIMIT (Eaccide $ 1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccidenq $ X X I $ Is A LIAR X OCCUR EXCESS LIAR j--� CLAIMSlv1ADE iCUP9748R372 10/01170 10/OtN 1 EACH OCCURRENCE $ 5,000,00 HUMBRELLA AGGREGATE $ 5,000,00 DEDUCTIBLE RETENTION $ 10,000 $ X 1 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4014736 BLANKET WANER OF SUBRO 07I01/11 07/01/12 X WC STATU- IOTH- TORY LIMITSLER_ E.L. EACH ACCIDENT $ 1,000,000 EL.DISEASE-EA EMPLOYEE$ 1,000,00C E.L. DISEASE -POLICY LIMIT 1 $ 1,000900D A Installation 81371`230 10/01110 10/01/11 Ded Install2,000,0010 DESCRIPTION OF OPERATIONS / LOCATIONS I 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 is included as Additional Insured for ongoing and com leted operations under General Liability. Exception: 0 da s written no 'ce of cancellation fo non- a ment ofpremium. CITYFCC CITY OF FORT COLLINS P.O. Box 580 FORT COLLINS, CO 80522 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 A © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD