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Home My WebLink About104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATE (3)OP ID: HC ,AFRO' CERTIFICATE OF LIABILITY INSURANCE DAT09121112 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 DIES Insurance Group - JT $848 Thompson Pkwy, Ste 200 Johnstown, CO 80534 John Hintzman t 0 C INSURED Greaory Electri( 3317 N. Lincoln Ave. Loveland, CO 80538 Phone:970-635-9400 Fax:970-635-9401 GREGO-3 INSURER A : Travelers IINSURER R,PinnacolAssurance 141190 1 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 BYYPPAID CLAIMS. INR POLJCYEx LTR TYPE OF INSURA NCE INSRADDLI MDII POLICY NUMBER MWDD/YYYY MMIDD/YVYY I LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR C09748R372 10/01112 10I01113 DAMAGETO RENTED PREMISES_(Ea occurrence)_ $ 300,000 MED EXP (Any one person) $ 10,000 PERSONAL& ADV INJURY $ 1,000,000 X BlanketAi Ins X Blkt Waiver GENERAL AGGREGATE $ 2,000,00 LIMITED POLLUTION GEN' L AGGREGATE LIMIT APPLIES PER-. PRODUCTS-COMP/OP AGG $ 2,000,00 RO LOC POLICY .l PIFCT $ A AUTOMOBILE LIABILITY ANY AUTO BA9748R372 10/01/12 10/01/13 COMBINED SINGLE LIMIT Ca accident) $ 1,000,00 X BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ A SCHEDULED AUTOS HIRED AUTOS PROPERTY DAMAGE (Peraccident) $ X X $ A NON -OWNED AUTOS BLANKET ADD'L INS. BLANKET WAIVER $ HUMBRELLA LIAB X I OCCUR EACH OCCURRENCE is 5,000,00 H AGGREGATE S 5,000,00 A EXCESS LIAR CLAIMS -MADE CUP9748R372 10/01/12 10/01/13 [X DEDUCTIBLE I $ Is RETENTION $ 10,000 B WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA 4014736 (BLANKET WAIVER OF SUBRO 07/01/12 07/01/13 WCSTPTU- OTT- X TORY_LIMITS ER E. L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE $ 1,000,000 If yes describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE -POLICY LIMIT $ 1,000,000 A '8137P230 10/01/12 10/01/13 Install 2,000,00 (installation Ded Soo DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Project: Exhibit Lighting for Fort Collins Museum of Discovery If required by written contract or written agreement, The City, its officers, agents and employees are included as additional insureds for ongoing operations under general liabilty and automobile liability. CITYFCI City of Fort Collins Attn: Purchasing Dept 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 UP ID: KC `'11. � CERTIFICATE OF LIABILITY INSURANCE DAT09/21112 ' 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 Phone:970-635-9400 CONTACT PFS Insurance Group - JT 4648 Thompson Pkwy, Ste 200 Fax: 970-635-9401 Johnstown, CO 80534 John Hintzman PHONE FAX AIc No Eag: (AID No): EMAIL -ADDRESS: PRODUCER GREGO-3 ID p: _CUSTOMER INSURER(S) AFFORDING COVERAGE NAIC# INSURED Gregory Electric, Inc. INSURER A: Travelers Companies 25615 3317 N.Lincoln Ave. INSURER B: Pinnacol Assurance 41190 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. ILSR TYPE OF INSURANCE INSRIWVDI ADOLTSUBR POLICY NUMBER MMIDOIYYYY�MMFDDIYEXP YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A GENERAL LIABILITY CLAIMSAIADE �OCCUR 'CO9746R372 10/01/12 10/01/13 DAMAGE TO RENTED PREMISES(Eaoccurrence) $300,000 MED EXP (Any one person) 8 10,000 kXCOMMERCIAL nketAdd'llns PERSONAL B ADV INJURY I$ 1,000,00t Waiver GENERAL AGGREcnrE $ 2,000,00 LIMITED POLLUTION GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X PECT n LOC Is A AUTOMOBILE LIABILITY ANY AUTO BA9748R372 10/01/12 10/01/13 COMBINED SINGLE LIMIT Ea accident) $ 1,000,00 X BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ A SCHEDULED AUTOS HIRED AUTOS PROPERTYDAMAGE (Per accident) $ X X $ A NON-OWNEDAUTOS BLANKET ADD'L INS. Is BLANKET WAIVER X UMBRELLA LIAB X OCCUR H EACH OCCURRENCE $ 5,000,000 AGGREGATE 5,000,000 $ A EXCESS LIAB CLAIMS -MADE CUP9748R372 10/01/12 10/01/13 DEDUCTIBLE $ X $ RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' ANY PROPRIETOF/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) N/A 4014736 BLANKET WAIVER OF BURRO 07/01/12 07/01/13 WC STATU- OTH-I X TCRY_LIMIT$�ER E.L. EACH ACCIDENT $ 1,000,00 E.L.OISEASE-EA EMPLOYEE .$ 1,000,00 If yes, describe untler DESCRIPTION OF OPERATIONS below EE LL DISEASE -POLICY LIMIT 1 $ 1,000,000 A Installation '8137P230 10/01/12 10/01/13 Install 2,000,000 Ded Soo DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addlllonal 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 days written notice of cancellation for non-payment 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 ©1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD