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430295 B W ELECTRIC SYSTEMS - INSURANCE CERTIFICATE
BWSYS-2 OP ID: L1 ,4�oRo CERTIFICATE OF LIABILITY INSURANCE DAT01117DIYYYY) 01117/13 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 719471-0262 Brown and Brown, Inc. 719471 2889 101 N. Cascade, Suite 410 Colorado Springs, CO 80903 House -Colorado Springs CONTACT NAME: Christine Bahrenbur ONE 719-387-2209 FA% PHAIC Na Ext: AIC No: 719471-2889 E"MAI ss: cbahrenburg@bbcosprings.com INSUREI AFFORDING COVERAGE NAIL N INSURERA: Transportation Insurance CO 20494 INSURED dba B W Systems B W Electric, Inc. B W Electric, Inc. 4305 Northpark Dr. Colorado Springs, CO 80907 INSURER B: Pinnacol Assurance 41190 INSURER C:America nCasual Co ofReadin PA 20427 INSURER D: INSURER E: INSURER IF 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 LTRINSR I TYPE OF INSURANCE ADDL SUEIR MD POLICY NUMBER MMIDDMYY MMIODIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR X C2088980040 07/15/12 07/15/13 DAMAGE TO RENTED PREMISES Ea occure rnce E 300,000 I EXP(Any one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO-LOC $ AUTOMOBILE LIABILITY COMBINED SI ROLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY Per person) $ C ANY AUTO X C2088979986 07/15/12 07/15/13 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per emblem) E NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Peraccidenl $ $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 C EXCESS LIAR CLAIMS -MADE C2088980085 07/15/12 07/15/13 DED X RETENTION$ 10,000 $ 1 B WORKERS COMPENSATION ANO EMPLOYERS' LIABILITY ANY PROPRIETORRARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? FN7 NIA 4039534 02/01113 02/01/14 WC STATU- OTH- X T RY LIMIT ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below E. L. DISEASE POLICY LIMIT 1 $ 1,000,000 DESCRIPTION OF gttacN ACORD 101, Additional Rennams Schedule, if more apace is required) formerl ,Colorado Systems Group, I� As requiretflzcen—concreec-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. CITYOFF City of Fort Collins Attn: Jim Hume PO Box 580 Fort Collins, CO 80524 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 C-,B.L ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD