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HomeMy WebLinkAbout104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATE (7)UN IU: RC ,acoRO CERTIFICATE OF LIABILITY INSURANCE ��- DATE 0/201 YV) O6I10/2013 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 NAMEc PFS Insurance Group - J7 4848 Thompson Pkwy, Ste 200 Fax: 970-635-9401 Johnstown, CO 80534 John Hintzman PHONE FAX Alc No Ear M, No); E-MAIL "ADDRESS: PRODUCER GREGO-3 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC# 'I, yy INSURED Gregory Electric, Inc. \O��T1 INSURER A: Travelers Companies 125615 3317 N. Lincoln Ave. Loveland, CO 80538 INSURER B: Pinnacol Assurance 141190 INSURER L 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. INSRPOLICYEFF EXP LTR rypE OF INSURANCE IADDLI WaRI POLICY NUMBER MMIDDIYYYYY MMIDDffTfY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A I X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE 1XI OCCUR C09748R372 10/01/2012 1010112013 DAMAGETORENTED PREMISES (Ed occurrence) $ 300,00 MED EXP (Any one person) $ 10,00 X Blanket Add'I Ins PERSONAL BADV INJURY $ 1,000,00 LIMITED POLLUTION X Blkt Waiver GENERAL AGGREGATE $ 2,000,00 GENL AGGRE�GGAT�TE LIMITAPPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,00 POLICY X PRO F LOC $ A AUTOMOBILE LIABILITY ANY AUTO BA974BR372 1010112012 10101/2013 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 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. X BLANKET WAIVER $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE Is 5,000,000 AGGREGATE $ 5,000,09 A E%CESS LIAR CLAIMS -MADE CUP9748R372 1010112012 1010112013 DEDUCTIBLE 8 X RETENTION $ 10,000 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED' (Mandatory In NH) NIA 4DI4736 BLANKET WANER OF SUBRO D7/D1/2013 D7/D1/2D14 WC STATU- TIT X TORY LIMITS R_ 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 Installation 813713230 10/01/2012 10/0112013 Install 2,000,000 Ded DESCRIPTION OF OPERATIONS I 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 ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009109) The ACORD name and logo are registered marks of ACORD