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506811 BW ELECTRIC DBA BW SYSTEMS - INSURANCE CERTIFICATE
BWSYS-2 OP ID: VJ '4t�� "* CERTIFICATE OF LIABILITY INSURANCE DAT07115D/YYYY) 07/15/13 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 endorsement(s). PRODUCER 719-471-0262 Brown and Brown, Inc. 719 471-2889 101 N. Cascade, Suite 410 Colorado Springs, CO 80903 Jason M Sartor CONTACT Jason Sartor PHONE 7Y0-9634263 FAX A/c No Ext): - A/c No): 71 9-387-2218 E-MAIL ADDRESS:jsartor@bbdenver.com INSURERS AFFORDING COVERAGE NAIC It INSURER A: AmericanCasualtyCo ofReadingPA 20427 INSURED dba B W Systems INSURER 8: Pinnacol Assurance 41190 B W Electric, Inc. 4305 Northpark Dr. INSURERC;TransportationInsuranceCc 20494 INSURER D �f Colorado Springs, CO 80907 \i INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBFR- 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. 1�TR TYPE OF INSURANCE ADDL SUER POLICY NUMBER MM/DDPOLICYIVYYY MM/DDfYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 MAGE TO RENTED PREMISES Ea occurrence $ 100,000 C X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxI OCCUR X C2088980040 07/15/13 02/01/14 MED EXP(Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO LOC Emp Ben. $ 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO X C2088979986 07/15/13 02/01/14 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE C2088980085 07/15/13 02/01/14 DED I X I RETENTION$ 10,000 $ B WORKERS COMPESATION AND EMPLOYERS' LTH IABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) N/A 4039534 02/01/13 02/01/14 X T RY LAMIT OER 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 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If 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. 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 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD