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Home My WebLink About263373 ELECTRONIC SYSTEMS INTERNATIONAL INC - INSURANCE CERTIFICATE (3)OP ID: SG A CERTIFICATE OF LIABILITY INSURANCE DATDYYYY) 12/29 12/29/11 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 NAM ECO TAGT Suzanne Storm -- - -- - . PHONE 719-590-9990 -(AIc,.No Eat); IAIc,No): 719-590-9992 E-MAIL ADDRESS sstorm@six-geving.comPRO- - - - to n: ELECT-1 _CUSTOMER INSURER(S) AFFORDING COVERAGE NAIC0 INSURED Electronic Systems INSURER A: COVerx Corporation INSURER B: Pinnacol Assurance 41190 International, Inc. 3010 Mallard Drive Colorado Springs, CO 80910-2247 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 ADD L SUER POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY E%P MMIODIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR - SDCGL339101 - '- 01/01/12 01101113 - EACH OCCURRENCE DAMAGE TO RENTED PREMISES Ea occurrence $ 1,000,00 8 50,00 MED EXP (Anyone person) $ — - 5,00 PERSONAL SADV INJURY $— ' GENERAL AGGREGATE- "S ----2,000,000 GENT AGGREGATE LIMIT APPLIES PER ' POLICY PRO- n.LOC.$ PRODUCTS - COMPIOP AGG $- - 2,000,00 C AUTOMOBILE LIABILITY- ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS L75688 ... ' 011011112 _ 01101/13 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ EODILV INJURY (Per aeGoenl) E PROPERTY DAMAGE (Per accitlenU $ $ $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE E DEDUCTIBLE RETENTION $ $ 'T Is B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANV PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED? (Mandatory to NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA g076606 01/01112 01/01/13 X WC STATU- OTH- TCRY LIMITS ER_ $ 500,00 E.L. EACH AccIDENr E.L. DISEASE - EA EMPLOYEE S 500,00 E.L. DISEASE -POLICY LIMIT E 500'000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 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 U 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD