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HomeMy WebLinkAbout506811 BW SYSTEMS / 430295 COLORADO SYSTEMS GROUP - INSURANCE CERTIFICATEBWSYS-2 OP ID: VJ '4�� "' CERTIFICATE OF LIABILITY INSURANCE DAT08113DIYYYY) F OS113/12 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 Brown and Brown, Inc. 11' 719�71-0262 101 N. Cascade, Suite 410V 1�'hi 718'471'2888 Colorado Springs, CO 80903 Tom Titsworth CONTACT NAME: Tom Titsworth ja"c°ii Ean:718-387-2202 Fa/c No : 719-471-2289 noDREss: tom!@bbcosprings.com INSURERS AFFORDING COVERAGE NAIC e INSURER A: Transportation Insurance Cc 20494 INSURED B W Systems INSURER B: Plnnacol Assurance 41190 B W Electric, Inc. dba 4305 Northpark Dr. INSURER C: American Casualty Ins Co of Colorado Springs, CO 80907 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 UBR POLICY NUMBER POLICY EFF MMIDDITYYY POLICY EXP MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1XI OCCUR X C2088980040 07/15/12 07/15/13 -CIAMA R NTED PREMISES Ee occurrence E 300,000 MED EXP (Any one person) E 5,000 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE E 2,000,00 GENT AGGREGATE LIMIT APPLIES PER: POLICY PRO-n LOC PRODUCTS -COMP/OP AGG $ 2,000,00 E AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT His amdent E 1,000,000 X BODILY INJURY (Per person) E C ANY AUTO X C2088979986 07/16/12 07/15/13 ALL OWNED SCHEDULED AUUTOSSAUTOS 80DILY INJURY (Per ac,adent) E NON -OWNED HIRED AUTOAUTOS X GE Wmacad.nl) E E X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE E 5,000,000 C EXCESS LIAB CLAIMS -MADE C2088980085 07/15/12 07/16/13 DIED I X I RETENTIONS 10000 $ B WORKERS COMPENSATION AND EMPLOYERS' LPPILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? NIA 4039534 02/01/12 02/01/13 X WC STATUS OTH- E.L. EACH ACCIDENT E 1,000,000 E.L. DISEASE EA EMPLOYEE E 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT E 1.000.00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ANach ACORD 101, AddlUonal Remarks Schedule, It more space Is required) formerly Colorado Systems Group, Inc. As required by written contract or agreement, the city, its officers, agents and employees are named as additional insureds with respects to general liability and automobile liability policies. 30 day notice of cancellation, 10 days for non payment of premium applies per policy form. City of Fort Collins Attn: Jim Hume PO Box 580 Fort Collins, CO 80524 CITYOFF 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 ACORD 25 (2010/05) © 1988.2010 ACORD The ACORD name and logo are registered marks of ACORD All rights reserved