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HomeMy WebLinkAbout430295 B W ELECTRIC INC DBA B W SYSTEMS - INSURANCE CERTIFICATE (2)BWSYS-2 OP ID: E1 ACORO" CERTIFICATE OF LIABILITY INSURANCE D01/28ATE /2016 Y) 01 /28/2016 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 Brown 8: Brown - Co Springs 2170 S. Parker Rd Ste 251 Denver, CO 80231 Jason Sartor CONTCONTACT Evie Jo Ontiveros PHONE FAX AD No Ext : 720-963 4286 A c No : 720-962-5142 ss: eontiveros@bbdenver.com ADDRESS, INSURERS AFFORDING COVERAGE NAIC # INSURER A: Charter Oak Fire Ins. Co 25615 INSURED B W Electric, Inc. - INSURER B: TRAVELERS PROP CAS. CO OF AMER 25674 dba B W Systems 4305 Colorado prinark s, Colorado Springs, CO 80907 INSURER C: Pinnacol Assurance Company 41190 INSURERD:HiscoxInsuranceCom an Inc. P 10200 INSURER E : INSURER F COVERAGES CERTIFICATE NLJMRFR- RFvminNi Nii IMrtFR- 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 INDL SUB POLICY NUMBER MM/DDY/YYYY EXP MM DDEFFYNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X CLAIMS -MADE D OCCUR X 4TC04F599088COF15 02/01/2016 02/01/2017 EACH OCCURRENCE $ 1,000,00 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,00 X MED EXP (Any one person) $ 10,00 D Prof Liab ANE52926916 02/01/2016 02/01/2017 PERSONAL& ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: POLICY1:1 PRO- ❑ JECT LOC GENERAL AGGREGATE $ 2,000,00 PRODUCTS-COMP/OP AGG $ 2,000,00 Prof Liab $ 1,000,00 OTHER: I I AUTOMOBILE LIABILITY COMBINED.SINGLE-LIMIT Ea accident)$ 1,000,00 X BODILY INJURY (Per person) $ A ANY AUTO X BA4F59908815CNS 02/01/2016 02/01/2017 ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accent Paccident) ) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLA LUlB X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00 B EXCESSLIAB CLAIMS -MADE 4TSMCUP4F599088TIL15 02/01/2016 02/01/2017 DED X RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N❑N OFFICERIMEMBER EXCLUDED? N/A 4039534 02/01/2016 02/01/2017 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ - 1,000,00 E.L. DISEASE - FA EMPLOYEE $ 1,000,00 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below - E.L. DISEASE - POLICY LIMIT $ 1,000,00 A Lease/Rent 4TC04F599088COF16 02/01/2016 02/01/2017 Lease/Ren 50,00 A BPP 4TC04F5990888COF16 02/01/2016 02/01/2017 BPP 100,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Per policy terms, conditions and exclusions As required by written contract or agreement, the city, its officers, agents and employees are named as additional insureds with respects to general liability and automobile liability policies. CITYOFF City of Fort Collins Attn: Jim Hume PO Box 580 Fort Collins, CO 80524 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 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD