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HomeMy WebLinkAbout350732 STURGEON ELECTRIC COMPANY INC - INSURANCE CERTIFICATE (2)AC 8 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F9/14/2018 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 NAME: Shannon Lentz Arthur J. Gallagher Risk Management Services, Inc. PHONE FAX 2850 Golf Road A/ o Ext): 630-285-4418 A/c No: 630-285-3922 Rolling Meadows IL 60008 ADDRIESS, Shannon_lentz@ajg.com INSURER(S) AFFORDING COVERAGE NAIC # _ INSURER A: Zurich American Insurance Company 16535 INSURED MYRGROU-01 INSURER B : American Zurich Insurance Company 40142 Sturgeon Electric Company, Inc. 12150 E. 112th Avenue INSURER C Henderson, CO 80640 INSURER D : _ INSURER E : COVERAGES CERTIFICATE NIIMRER-9459R7156 REVISION NLIMRFR- 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 ADDL SU POLICY NUMBER POLICY EFF / /YYY POLICY EXP MM/D /YYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y GL0837415424 9/30/2018 9/30/2019 EACH OCCURRENCE $1,000,000 DA AG PREMISES Ea occurrence) r ) $100.000 _—�_— MED EXP (Any one person) $10,000 PERSONAL& ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO- JECT 7 LOC OTHER: GENERAL AGGREGATE $ 2,000.000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Y BAP837415M2 9/30/2018 9/30/2019 COMBINEDSINGLE LIMIT Ea accident $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERWEMBE R EXCLUDED? F7N (Mandatory in NH) M yes, describe under DESCRIPTION OF OPERATIONS below N/A WC837415222 A/O/S)) WC837415322 �MA WI) 9/30/2018 9430/2018 OW2019 Wl30/2019 X STATUTE OER 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, maybe attached if more space Is required) Job: City of Fort Collins - T&M Service %,tH I IrIL A I t NULLItH 1.,AN1rtLLA I IVN 1542 The City of Fort Collins Purchasing Department PO Box 580 Fort Collins CO 80522 USA 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD