Loading...
HomeMy WebLinkAbout104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATEA RO® CERTIFICATE OF LIABILITY INSURANCE D/ 6/24//24/2015015 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). PRODUCER Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT Nikki Mosbrucker CIC, CISR NAME: PHONE (970) 266-7123 FAX N A C, No). (970)506-6823 E-MAIL .NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC q INSURERA:Travelers Insurance Co INSURED Gregory Electric, Inc. 3317 N. Lincoln Ave. PO Box 2373 Loveland CO 80539 INSURERB:Pinnacol Assurance INSURER C:Hous ton Casualty INSURERD: INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER:CL1562403853 REVISION NUMBER: 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 UBR POLICY NUMBER POLICY EFF MM DDNYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE To RENTED PREMISES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 10,000 A CLAIMS -MADE 7 OCCUR X 4TC05D974152COF14 10/1/2014 10/1/2015 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 $ POLICY X PRO 71 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea acc ident 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO A ALL OWNED SCHEDULED X A5D97415214CNS 0/1/2014 0/1/2015 BODILY INJURY (Per accident) $ AUTOS AUTOS X X NON -OWNED PROPERTY DAMAGE (Per accident) $ HIRED AUTOS AUTOS Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ X 4TSMCUP5D974152TIL14 0/1/2014 0/l/2015 B WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? FN7 (Mandatory in NH) N/A 014736 /1/2015 /1/2016 E.L. DISEASE- EA EMPLOYE . $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 If es, describe under DESCRIPTION OF OPERATIONS below A Installation Floater QT660367M1606TIL14 10/1/2014 10/1/2015 $2,000,000Limit /$500Ded. C Contractor's Professional HCC1563745 1/1/2015 1/1/2016 $1,000,000Limit /$25,000Ded. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Fort Collins, its officers, agents and employees are included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. CERTIFICAI I- H City of Fort Collins Purchasing Dept PO Box 580 Fort Collins, CO 80522-0000 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 (2010/05) INS025 I20100s 01 N Mosbrucker CIC,CISR © 1988-2010 ACORD CORPORATION. All rights reservea. The ACORD name and loco are reaistered marks of ACORD AC" E® CERTIFICATE OF LIABILITY INSURANCE 6/24/2015 Y) 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). PRODUCER Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT NAME: Nikki Mosbrucker CIC, CISR PHONE (970) 266-7123 FAXA/CWC, 9701506-6823 E-MAIL .NMosbrucker@floodpeterson.com INSURERS AFFORDING COVERAGE NAIC k INSURER A:Trave 1 ere Insurance Co INSURED Gregory Electric, Inc. 3317 N. Lincoln Ave. PO BOX 2373 Loveland CO 80539 INSURERB:Pinnacol Assurance INSURER C Houston Casualty INSURERD: INSURER E: INSURERF: COVERAGES CERTIFICATE NUMBER:CL1562403853 REVISION NUMBER: 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. INSRPOLICY LTA TYPE OF INSURANCE ADDL UBR POLICY NUMBER EFF MM DDNYYY POLICY EXP MM/DDNYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY UAMAUL I U HLN f ED300,000 PREMISE Ea occurrence $ A CLAIMS -MADE F7X OCCUR X 4TC05D974152COF14 10/1/2014 10/1/2015 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,000 $ POLICY X PRO- IFCT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X A5D97415214CNS 10/1/2014 10/1/2015 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ X X NON -OWNED HIRED AUTOS AUTOS Uninsured motorist combined $ 1,000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ S X 4TSMCUP5D974152TIL14 10/1/2014 10/1/2015 B WORKERS COMPENSATION X I WC STATU- I OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N/A 4014736 /1/2015 /1/2016 E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYE $ 1 000 000 E.L. DISEASE - POLICY LIMIT $ 1,0001000 If yes, describe under DESCRIPTION OF OPERATIONS below I A Installation Floater T660367M1606TIL14 0/1/2014 10/1/2015 $2,000,000 Limit/ $500 Ded. C Contractor's Professional CC1563745 /1/2015 1/1/2016 $1,000,000 Limit / $25,000 Ded. DESCRIPTION OF OPERATIONS! LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Exhibit Lighting for Fort Collins Museum of Discovery. The City of Fort Collins, its officers, agents and employees are included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. CERTIFICATE HOLDER City of Fort Collins Purchasing Dept PO Box 580 Fort Collins, CO 80522-0000 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 Mosbrucker CIC, CISR YG�r .__c� ACORD 25 (2010/05) INS0251201005) 01 ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and Joao are registered marks of ACORD