HomeMy WebLinkAbout263373 ELECTRONIC SYSTEMS - INSURANCE CERTIFICATE (2)ELECT-1 OP ID: SG
,a►c`oRo CERTIFICATE OF LIABILITY INSURANCE DATE 12130/20/3 V)
12130I2013
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 Phone: 71
iix & Geving Insurance, Inc.
1630 Sinton Road, Suite 200 Fax: 71
:olorado Sorinas. CO 80907-5034
INSURED Electronic Systems _ /
International, Inc. �d733f7 1 3
3010 Mallard Drive
Colorado Springs, CO 80910-2247
Suzanne Storm
E,n); 719-590-9990 iac. Noe 719.590-9992
Pinnacol Assurance
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
84
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 TYPE OF INSURANCE j POLICY NUMBER MIAI UIYYYYY MM UD/Y'/EYXYPY LIMnD
T
GENERAL LIABILITY
EACH OCCURRENCE
S 21000,00
DAMAGE TORENpurD
E 100,00
A
X COMMERCIAL GENERAL LIABILITY
103GL000166,1I
01101/20114
01/01/2015
CLAIMS -MADE I OCCUR
MED EXP (Any one person)
S 5,00
PERSONAL S ADV INJURY
$ 2,000,
GENERAL AGGREGATE
$ 3,000,001
GEWL AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMPIOP AGO
S 3,000,0011
S
POLICY PRO LOC
AUTOMOBILE LIABILITY
OMBINED SINGLE LIMIT
(Ea aaleenl
1,000,
BODILY INJURY (Per pawn)
E
C
X ANVAVTO
L75688
01/01/2014
01/01/2015.
BODILY INJURY (Per accident)
$
ALL OWNED SCHEDULED
AUTO$ AUTOS
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
Per accident
S
S
UMBRELLA LUIB OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR CLAIMS -MADE
$
DED 1 1 RETENTION
WORKERS COMPENSATION
H-
X WCSTI U. MITq GET
B
AND EMPLOYERS' LIABILITY Y / N
PROP
4076MB
07701/2014
01/01/2015
E.L. EACH ACCIDENT_
S. 1,000,00
OFFICERIMEMBER EXCLUDED9
(Mandatory In NO'R/PARTNER/EXECUTIVE �
MIA
L_E _.
-----
EASE-EAEMPLOYE
_
S 1,000,00
E.L. DISEASE -POLICY LIMIT
S 1,000,00
If yes. desrnbe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is wulreJ)
CFRTIFICATF HOLDER CANCELLATION
CITYF-2
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Ft. Collins
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Director of Purchasing
and Risk Management
AUTHORIZED REPRESENTATIVE
P.O. Box 580
Ft. Collins, CO 80522-0580
01988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD