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HomeMy WebLinkAbout104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATE (11). %. O� CERTIFICATE OF LIABILITY INSURANCE `5 918/ D/18//DD/Y2015 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 CONTACT NAME: Nikki Mosbrucker CIC, CISR Flood and Peterson PO Box 578 PHONE (970) 266-7123 A/C No: (970)506-6823 Ao RILESSNMosbruckerQfloodpeterson.com INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Charter Oak Fire Insurance 25615 INSURED INSURERB;Travelers Property Casualty 25674 Gregory Electric, Inc. INSURERc:Pinnacol Assurance 41190 INSURERD: 3317 N. Lincoln Ave. Po Box 2373 INSURER E: Loveland CO 80539 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1591805715 REVISION NIIMRFR- 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 INSR SUER WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO PREMISES RENTbu occurrence) $ 300,000 A CLAIMS -MADE OCCUR X TC05D974152COF15 0/1/2015 0/1/2016 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY X PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 X BODILY INJURY (Per person) $ A ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS BA5D97415215CNS 0/1/2015 0/1/2016 NON -OWNED HIRED AUTOS N AUTOS X PROPERTY DAMAGE Per accident) ccident $ Uninsured motorist combined $ 1 000,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 F4EXCESS AGGREGATE $ 5,000,000 B LIAB CLAIMS -MADE DED RETENTION$ $ X 4TSMCUP5D974152TIL15 0/1/2015 0/1/2016 C WORKERS COMPENSATION X I WC STATU- OTH- FR AND EMPLOYERS' LIABILITY Y / NOR, E.L. EACH ACCIDENT $ 1 000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE N N/A OFFICER(Mandao/MEMBER ryinNH)EXCLUDED? 014736 /1/2015 /1/2016 E.L. DISEASE- EA EMPLOYE $ 1,000,000 If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below B Installation Floater T660367M1606TIL15 0/1/2015 [1/112116 $ 2,1100,100 Lim it 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. %.F-n I IrIVH I r- nULUcn 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 AL;UKU Zb (ZU1WUb) INS025 (201005).01 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD