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HomeMy WebLinkAbout104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATE (6)UP ID: KG ,4cRo. CERTIFICATE OF LIABILITY INSURANCE oAT09/27/11�1 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 PRODUCER IFS Insurance Group - JT 1848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 John Hintzman INSURED Gregory Electric, Inc. 3317 N. Lincoln Ave. Loveland, CO 80538 REGO-3 INSURER A: Travelers Companies I INSURER R: Pinnacol Assurance 524210 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. ILTRNSR TYPEOFINSURANCE ADDOSU"SRiMDi POLICY NUMBER MMIDDY EFP,FFp�YnEYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE I $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR C09748R372 10/01/11 10/01112 DRMEMIGSEETOENcTcEDenceI$ 300,00 MED EXP (Any one person) $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 X Blanket Add'I Ins X Blkt Waiver GENERAL AGGREGATE s 2000,0" LIMITED POLLUTION GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $ 2:000,000 POLICY A I PRO n LOC I$ A AUTOMOBILE LIABILITY ANY AUTO BA9748R372 10/01111 10101112 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) IS ALL OWNED AUTOS BODILY INJURY (Per accident $ A SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Per accident) $ X X $ A NON-OWNEDAUTOS BLANKET ADD'L INS. Is BLANKET WAIVER LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 HUMBRELLA AGGREGATE $ 5,000,00 A EXCESS LIAB CLAIMS -MADE CUP974BR372 10101111 10/01112 DEDUCTIBLE I $ X RETENTION $ 10,000 Is B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTI SYIN OFFICERIMEMBER EXCLUDED? (Mandatory, In NH) MIA 4014736 BLANKET WAIVER OF SUBRO 07/01/11 07/01/12 X WC STATU- O" TORV LIMITS ER I E.L. EACH ACCIDENT $ 1,000,00 E. L. DISEASE - EA EMPLOYEE!$ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,00 A Installation 813711`230 10/01/11 10/01/12 Install2,000,00 Ded DESCRIPTION OF OPERATIONS I 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 completed operations under General Liability. Exception: 10 da s written notice of cancella io 0 0 - a e of premium. 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 4a P `--' ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD