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Home My WebLink About263373 ELECTRONIC SYSTEMS INTERNATIONAL - INSURANCE CERTIFICATEELECSYS-01 SSTORM A� CERTIFICATE OF LIABILITY INSURANCE (MM/D 1FDATED/YYYY) (MMID018 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 Suzanne Storm HONE No, Ext : (719) 867-4502 FAX No :(719) 590-9992 Six & Geving Insurance, Inc. 3630 Sinton Road #200 Colorado Springs, CO 80907 E-MAIL , sstorm@six-geving.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Colony Insurance Company 39993 INSURED INSURER B : Acuity 14184 INSURER C: Pinnacol Assurance 41190 Electronic Systems International, Inc. INSURER D : 3010 Mallard Drive Colorado Springs, CO 80910-2247 INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 2 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 LTRM TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF D POLICY EXP MM DD YY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑X OCCUR X 103GL0001664-05 1/1/2019 1/1/2020 EACH OCCURRENCE 2,000,000 DAMAGE TO R(EaENTEDPR ISES occurrence) $ 100,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY 2,000,000 GEN.L AGGREGATE LIMIT APPLIES PER: PRO- ❑JPRO ECT❑ LOC OTHER: I GENERAL AGGREGATE 3,000,000 PRODUCTS -COMP/OP AGG 3,000,000 B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X L75688 1/1/2019 1/1/2020 COMBINED SINGLE LIMIT 1,000,000 BODILY INJURY Perperson) BODILY INJURY Per accident PROPERTY DAMAGE Per accident UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE AGGREGATE DED I I RETENTION $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN OFFICER/MEMBOERANY /EXCLUDED? ECUTIVE ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N f A 4076606 1 /1 /2019 1 /1 /2020 PER OTH- A LITE 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 I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: City of Ft. Collins is hereby added as additional insured with regards general liability & automobile liability coverage per written contract. Ida City of Ft. Collins P.O. Box 580 Ft. 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 ACORD 25 (2016/03) @ 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD