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Home My WebLink About430295 B W ELECTRIC INC DBA B W SYSTEMS - INSURANCE CERTIFICATEBWSYS-2 OP ID: E1 CERTIFICATE OF LIABILITY INSURANCE DAT01/28/15YYI 1 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 719-471-0262 NAMEACT Evie Jo Onitiveros Brown & Brown -Co Springs 720.962-5142 101 N. Cascade Ave Ste B3 Colorado Springs, CO 80903 PHONE 720-963-0286 FAX AIC No Ext ac Na : 720-962-5142 pooREss: ejoontiveros@bbdenver.com Jason Sartor INSURERS AFFORDING COVERAGE NAIC k INSURER A: Charter Oak Fire Ins. CO 25615 INSURED B W Electric, Inc. INSURER B: TRAVELERS PROP CAS. CO OF AMER 25674 dba B W Systems 4305 Northpark Dr. INSURER C: Pinnacol Assurance Company 41190 Colorado Springs, CO 80907 INSURER D: INSURER E: INSURER F: COVFRAGFS 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 TR TYPE OF INSURANCE DL SUER POLICY NUMBER MMDDY/YYYY MMLDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X 4TC04F599088COF15 02/01/15 02/01/16 PREMISES Ea c.urrehce $ 300,00 MED EXP (Any one person) $ 10,00 CLAIMS -MADE FxI OCCUR PERSONAL 8 ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,00 $ POLICY X PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,00 BODILY INJURY (Per person) $ B X ANY AUTO X BA4F59908815CNS 02/01/15 02/01116 BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Peraccitlent $ $ X UMBRELLALIAB X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00 B EXCESS LIAR CLAIMS -MADE 4TSMCUP4F599088TIL15 02101115 02/01/16 DED I X I RETENTION$ 10000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y� ANY PROPRIETOR/PARTNER/EXECUTIVE 4039534 02101115 02/01/16 X WC STATU- ETH- M ITST E.L. EACH ACCIDENT $ - 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA E L DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,00 If yes, describON OF OPERATIONS below e untler DEyes RIPTI A Lsd/Rntd Equip 4TC04F599088COF15- 02/01/15 02/01/16 Lease/Ren 50,00 DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Per policy terms, conditions and exclusions 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. CFRTIFICATF HOLDER CANCELLATION CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins Attn: Jim Hume AUTHORIZED REPRESENTATIVE Po Box 580 Fort Collins, CO 80524 _ _ - ^ ,; tl�^� (�,�'CJ`L'c��, ,(pi�j0,(`�/`'c-vCJGCJ 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD