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HomeMy WebLinkAboutSTURGEON ELECTRIC COMPANY INC - INSURANCE CERTIFICATEACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDlYVYY) 1 7/11/2017 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 CONTACT NAME: Shannon Lentz Arthur J. Gallagher Risk Management Services, Inc. PHONE 630-285-4418 FAX 630-285-3922 C. Two Pierce Place Itasca I L 60143 E-"e RLE . shannon_lentz@ajg.com INSURERA:Zudch American Insurance Company 16535 INSURED MYRGROU-01 INSURER B:American Zurich Insurance Company 40142 Sturgeon Electric Company, Inc. INSURERC: 12150 E. 112th Avenue Henderson, CO 80640 INSURERD: INSURER F : rnllGDA(LFC CFDTIFICATF NI IMRGD• 104990464 DFVICInIU NIIRARFD- 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 15 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 IN D POLICY NUMBER POLICY EFF DIYYYY POLICY EXP MMODIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY X❑ OCCUR Y GLOB37415422 9/3012016 9/30/2017 EACH OCCURRENCE $1,000,000 -DAMACLAIMS-MADE PREMISES Ea occurrence $100,000 MED EXP (Any one person) E 10,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PE LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OP AGG f 2,000,000 f A AUTOMOBILE LIABILITY ANY AUTO ALLOSNED SCHEDULED ANON -OWNED HIRED AUTOS AUTOS Y BAPS37415520 9/3012016 9/30/2017 INGLE LIMIT Ea accWent E 1,000,000 X BODILY INJURY (Per person) E BODILY INJURY (Per accident) f accident) E -(Per E UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE E AGGREGATE E DED I I RETENTION E f B A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC837415220 (A/O/S) WC837415320(MA/WI) 9/3012016 9/30/2017 9/3012016 9/30/2017 X OTH- STATUTE ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Job: City of Fort Collins - T&M Service f`FDTIFICATF 14ni IIFD rANCFI I ATinN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1542 The City of Fort Collins Purchasing Department THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins CO 80522 AUTHO('RIIIZEZE'D/REPRESENTATIVE USA © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD