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HomeMy WebLinkAboutEGGERS ELECTRIC INC - INSURANCE CERTIFICATE (3)EGGER-1 OP ID: JW1 TE ,acoRO CERTIFICATE OF LIABILITY INSURANCE DA 12/3112018018Y) /31 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 endorsement(s). CONTACT PRODUCER Phone:970-223-1804 NAME: Front Range Insurance Group PHONE FAX — 2002 Caribou Drive, Ste. 101 Fax: A/c No Ext: I ac No: Fort Collins, CO 80525 E-MAIL Steven G. Smith ADDRESS: INSURED Eggers Electric, Inc. 3520 W. Eisenhower Blvd. Loveland, CO 80537 INSURER A: Travelers Indemnity Compam INSURER B : Travelers Casualty Insurance INSURER C : Pinnacol Assurance INSURER D : INSURER E : CCIVFRAnFR CFRTIFICATF NIIMRFR- RFVLSInN NI IMRFR- 190 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 A DL SUB POLICY NUMBER EFF MM/DDPOLICYYYYY D CY EXP MM/D/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I ^ I OCCUR 680-3F873072-19-42 01/01/2019 01/01/2020 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 300,000 $ 5,000 $ 1,000,000 MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS BA-5K064325-18 01/01/2019 01/01/2020 COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS LWB X OCCUR CLAIMS -MADE CUP-4F079685-19-42 01/01/2019 01/01/2020 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,00 DED X I RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? F-] (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 4076793 06/01/2018 06/01/2019 WC STATU- OTH- LIMITS E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) UtK I II-IUA I t MULLJtK FORTC-1 City of Fort Collins Attn: Delynn P.O. Box 580 Fort Collins, CO 80522-0580 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD EGGER-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: General Liability: CGD186 (02/19) - Additional Insured -Ongoing Operations, Waiver of Subrogation CGD037 (04/05) - Primary/Non-Contributory for Additional Insureds Auto Liability: CAT420 (02/15) - Additional Insured, Waiver of Subrogation orkers Compensation: 359b - Waiver of Subrogation