HomeMy WebLinkAbout105347 ITRON INC - INSURANCE CERTIFICATE (3)ACORO® CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
09/28/2018
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 have ADDITIONAL INSURED provisions or 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
CONTACT Jennifer Winter, CISR
NAME:
Flood and Peterson
PHONE (970) 506-3206 FAX (970) 506-6846
A/C No Ext : AJC, No
PO Box 578
E-MAIL JWinter@floodpeterson.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
Greeley CO 80632
INSURER A: Phoenix Insurance Company
25623
INSURED
INSURER B: Travelers Indemnity Company
25658
J2 Contracting Company, Inc.
INSURERC: Travelers Property Casualty Company ofAmerica
25674
105 Coronado Court, SuiteA101
INSURERD: Pinnacol Assurance
41190
INSURER E :
Fort Collins CO 80525
INSURER F :
COVERAGES CERTIFICATE NUMBER: CL1892825374 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
LTR
TYPE OF INSURANCE
AUDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MMIDOIYYYY
POLICY EXP
MM/ODIYYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE � OCCUR
EACH OCCURRENCE
$ 1,000,000
PREMISES Ea occurrence
$ 300,000
X
ME EXP (Any one person)
$ 5.000
PD Ded:2,500
PERSONAL &ADV INJURY
$ 1,000,000
A
DTC0325D6576PHX18
01/01/2018
01/01/2019
GEN'LAGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
GENERAL AGGREGATE
$ Z000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANYAUTO
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
DT810325D65761ND18
01/01/2018
01/01/2019
BODILY INJURY (Per accident)
$
X
HIRED v NON -OWNED
AUTOS ONLY /�, AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
X
$
DOC
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
AGGREGATE
$ 5,000,000
C
EXCESS LIAB
CLAIMS MADE
CUP9H7218771826
01/01/2018
01/01/2019
GED I X RETENTION $ 10,000
$
D
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? F7
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
3114522
10/01/2018
10/01/2019
PER OTH -
X STATUTE I ER
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
E.L. DISEASE - POLICY LIMIT
$ 1.000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: Contractors License
The City of Fort Collins is listed as an Additional Insured as respects General Liability. Insurance is primary and non-contributory. A 30-day written notice of
cancellation applies.
ML)LlJtK
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Attn: Engineering Department ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522-0580
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