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HomeMy WebLinkAboutEGGERS ELECTRIC INC - INSURANCE CERTIFICATE (2)EGGER-1 OP ID: JW1 ,acoR�" CERTIFICATE OF LIABILITY INSURANCE DATE 12131 /2018Y) 12/31/2018 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 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 Phone: 970-223-1804 NAME, CONTACT Front Range Insurance Group PHONE FAX 2002 Caribou Drive, Ste. 101 Fax: A/C. No. Ext): _ No): Fort Collins, CO 80525 E-MAIL Steven G. Smith ADDRESS: INSURER A: Travelers Indemnity Company INSURED Eggers Electric, Inc. INSURERS: Travelers Casualty Insurance _ 3520 W. Eisenhower Blvd. INSURER C:Pinnacol Assurance 41190 Loveland, CO 80537 — — - INSURER D : INSURER E INSURER F rOVFRAGFS CFRTIFICATF NIIMRFR- RFVISInN 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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIALGENERALLIABILITY 680-3FB73072-19-42 01/01/2019 01/01/2020 PREMISES Ea occurrence $ 300,000 CLAIMS -MADE I OCCUR MED EXP (Any one person) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,00 BODILY INJURY (Per person) $ B X ANY AUTO BA-SK064325-18 01/01/2019 01/01/2020 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ _ HIRED AUTOS NON -OWNED AUTOS X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 A EXCESS LIAR CLAIMS -MADE CUP-4FO79685-19-42 01/01/2019 01/01/2020 DED I X I RETENTION $ 10,000 $ WORKERS COMPENSATION WC STATU- OTH- C AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N 4076793 06/01 /2018 06/01/2019 E.L. EACH ACCIDENT $ 1,000,00 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HULDER CANCELLA I IUN FORTC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 281 North College Avenue Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD EDGER-1 PAGE 2 NOTEPAD INSURED'S NAME Eggers Electric, Inc. OP ID: JW1 DATE 12/31/18 If required by written contract, the following forms apply on a blanket basis: eneral Liability: GD186 (02/19) - Additional Insured -Ongoing Operations, Waiver of ubrogation GD037 (04/05) - Primary/Non-Contributory for Additional Insureds o Liability: 420 (02/15) - Additional Insured, Waiver of Subrogation orkers Compensation: 59b - Waiver of Subrogation