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563039 GREINER ELECTRIC LLC - INSURANCE CERTIFICATE
ACORD, CERTIFICATE OF LIABILITY INSURANCE F DATE(MM/DD/YYYY) 10/1/2019 9/28/2018 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 Lockton Companies 8110 E Union AvenueI Suite E Denver CO 80237 COW ryTACT hi FAX, A/C No EXt : AIC No): E-MAIL ADDRESS: INSURER AFFORDING COVERAGE N IC n (303) 414-6000 INSURER A: 'Fhe Phoenix Insurance Company 25623 INSURED Greiner Electric LLC 1344709 12456 Dumont Way Littleton, CO 80125 INSURER B : Plnnacol Assurance Company 41 190 INSURER C : The Charter Oak Fire Insurance Company 25615 INSURER D : INSURER E: I he Travelers Indemnity Company 25658 INSURER F COVERAGES GREELOO CERTIFICATE NUMBER_ 12671646 RFVIRION NIIMRFR: XXXXXXX 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 INSD SUER WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y N D7-00-9J170303-PHX-18 10/1/2018 10/1/2019 EACH OCCURRENCE 1,000,000 PREM SES (E. occurrence 300,000 MED EXP (Any oneperson) 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- ❑ LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 C AUTOMOBILE LIABILITY ANY AUTO AUTOSONLY WNED SCHEDULED AUTOS AUTOS ONLY X AUUTOS ONE Y N DT-810-9JI70303-COF-18 10/1/2018 10/1/2019 (COaBINEDdentSINGLE LIMIT $ 11000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX X Peroa. den DAMAGE $ XXXXXXX $XXXXXXX E LIAB EXCESS LIAB [IOCCUR CLAIMS -MADE N N CUP-9J206629-18-26 10/1/2018 10/1/2019 EACH OCCURRENCE $ 10,000,000 rUMBRELLA AGGREGATE $ 10,000,000 DED RETENTION $ $ XXXXXXX B WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY OFFICER/MEMBER EXCLUDED? ECUTIVE N❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA N 4006279 10/l/2018 10/1/2019 PER OTH- X STATUTE ER E L. EACH ACCIDENT $ 11000,000 EL DISEASE - EA EMPLOYEE 1,000,000 E L DISEASE - POLICY LIMIT 1 ,000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins is included as additional insured with respect to general liability and auto liability as required by written contract. %Irm 11111 r_ MuLuCr( UANL;tLLA I IUN See Attachments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12671646 AUTHORIZED REPRESENTATIVE The City of Fort Collins Purchasing Department P.O. Box 580 Fort Collins, CO 80522 C ACORD 25 (2016/03) ©1 812015 ACORD CORPO ATION- All rights reSPrvPrf The ACORD name and logo are registered marks of ACORD