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Home My WebLink About104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATE (9)Client#: 34521 GREEL7 ACORD.CERTIFICATE OF LIABILITY INSURANCE DATED%YYYY) 9/18/20/2014 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 endomement(s). PRODUCER Flood & Peterson Ins., Inc. P. 0. Box Greeley, CO 80632 970356-0123 CONTACT NAME: Nikki Mosbrucker, CIC, CISR PNONE 970 266-7123 970 506-6823 AIL No Eat: AIC No A DDDDDR REESS: nmosbrucker@Roodpeterson.com INSURERS AFFORDINGLOVERAGE NAILS INSURER A: Travelers Insurance Company INSURED Gregory Electric, Inc. 3317 N. Lincoln Ave. INSURERB: Pinnacol Assurance INsuRERc: Loveland, CO 80538 INSURERD: 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 CONTRACTOR 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 LTR TYPE OF INSURANCE DO I SUB POLICY NUMBER POLICY EFF MID POLICY UP MNID 11Mn5 A GENERAL LIABILITY X COMMERCIALGENERALLIABILRY CLAIMS -MADE 51OCCUR X X 4TCOSD974152- COF14 0/01/2014 10/01/201 OCCURRENCE S1,000,000 EEAACCHH PREMISES EZEaNTErrence s3000OO MED UP (Any one person) $1 O 000 PERSONAL S ADV INJURY $1 009 000 GENERAL AGGREGATE s2,000,000 GENL AGGREGATE POLICY LIMIT APPLIES PER: X PRO- LOC PRODUCTS-COMPIOPAGG f2,000000 f A AUTOMOBILE LIABILITY ANY AUTO ALLOOS NED SCHEDULED AUTOS HIREDAUTOS X NON -OWNED AUTOS X X BA5D97415214CNS 0/0112014 10/0112015 COMBINED SINGLE LIMIT $1,000,000 X BODILY INJURY (Per person) S BODILY INJURY (Per ec ident) $ X PROPERTY DAMAGE P acrdent f f A X UMBRELLA LAB EXCESS LIAR X OCCUR CLAIMS -MADE X X 4TSMCUP5D974152- TIL14 0101/201410/01/201 EACH OCCURRENCE f5000000 AGGREGATE $S 00O 000 DED I I RETENTIONS S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTIIENEXECUTNE YIN OFFICER EMBER EXCLUDED? N rmar.h"to NM) Nyaa deso3e under DESCRIPTION OF OPERATIONS Oebv: NIA 'X 4014736 7/01/2014 07/01/201 XWCSTATU- OTH- E.L. EACH ACCIDENT $11000.000 E.L. DISEASE -EA EMPLOYEE S1 OGOOOO E.L.OISEASE-POUCYUMIT f1 000,000 A Installation Floater QT660367M1606TIL14 1010112014 10/01/2015 $2,000,000 Limit $ 500 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addlilonal Remerlte ScMtlWe, N more aWce Is required) The City of Fort Collins, its officers, agents and employees are included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named Insured. City of Fort Collins Attn: Purchasing Dept. PO 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. 01998.2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) 1 of 1 The ACORD name and logo are registered marks of ACORD #S936336/M936274 NIK Client#: 34521 GREELt ACORD. CERTIFICATE OF LIABILITY INSURANCE DATEIMMIDDIYYYY) 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 Flood & Peterson Ins., Inc. P. O. Box 578 Gr Greeley, CO 80632 97eeley CONTACT NAME: Nikki Mosbrucker, CIC, CISR PNONE g70 266-7123 _F E'd, ac N°: 970 506-6823 ErnAa° ADDRESS: nmosbrucker@floodpeterson.com INSURER(S)AFFORDING COVERAGE NAICN INSURER A: Travelers Insurance Company INSURED Gregory Electric, Inc. 3317 N. Lincoln Ave. INSURER B: Plnnacol Assurance INSURER C: Loveland, CO 80538 INSURERD: INSURER E : NSURERF: 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 CONTRACTOR 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. LTRR TYPE OF INSURANCE ADDLSUBR NSR MD POLICY NUMBER MM/LDOYEFF MMIDOYYYP LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X X 4TC05D974152- COF14 I 010112014 1010112015 EACH OCCURRENCE $1000000 PREMISES ERENTE0 i aocwnence $300ODD MED EXP (My one person) $10000 PERSONAL S ADV INJURY $1000000 GENERA -AGGREGATE S2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PER: HI -X JECT LOC .PRODUCTS - COMP/OP AGO $2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULEp AUTOS AUTOSBODILY HIRED AUTOS X NONOINED AUTOS X X BASD97415214CNS 0/01/2014 1010112011 COMBINED SINGLE LIMIT Ea accident $1,000,000 IX BODILY INJURY(Per person) $ INJURY (Per accitleni) $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LIAR EXCESS LIAR X OCCUR CLAIMS -MADE X X 4TSMCUP5D974152- TIL14 101011201410101/201 EACH OCCURRENCE $5000000 AGGREGATE $S 000 000 DIED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OPFICERIMEMBER EXCLUDED? (Mandatory in NH) '-" If yes, ribe under D SCRIPTIONOFOPERATIONSbelow NIA X 4014736 7/01/2014 O7/O1/201 X WC STATU- OTH- E.L. EACH ACCIDENT E1 OOO OOO __ .L. EDISEASE-EA EMPLOYEE _ $1006000 EI.DISEASE - POLICY LIMIT $1 000000 A Installation Floater OT660367M1606TIL14 0/01/2014 10/01/2015 $2,000,000 Limit $ 500 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, K more space is required) RE: Exhibit Lighting for Fort Collins Museum of Discovery. The City of Fort Collins, its officers, agents and employees are included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. City of Fort Collins Attn: Purchasing Dept. PO 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. CORPORATION. All rights reserved. ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S936334/M936274 NIK