HomeMy WebLinkAbout104571 GREGORY ELECTRIC INC - INSURANCE CERTIFICATE (13)A`o " CERTIFICATE OF LIABILITY INSURANCE
DATE /01/20/18
06/01l2018
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
Flood and Peterson
PO Box 578
Greeley CO 80632
CONTACT Dana Stewart, CIC, CISR
PHONE (970) 266-7149 A/C, No (970) 506-6845
AfC No Ext
E-MAILADDRESS: DStewart@floodpeterson.com
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A : Charter Oak Fire Insurance Company
25615
INSURED
Gregory Electric, Inc.
3317 N. Lincoln Ave.
Loveland CO 80539
INSURER B : Travelers Property Casualty Company of America
25674
INSURER C : Plnnacol Assurance.
INSURER D :
INSURER E :
INSURER F
COVERAGES CERTIFICATE NUMBER' CL186123581 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
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DD/1^/W
POLICY EXP
MM1DOlYYYY
LIMITS
X
COMMERCIALGENERALLIABILITY
CLAIMS -MADE I -XI OCCUR
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 300,000
MED EXP (Any one person)
$ 10,000
A
DT-CO-5D974152-COF-17
10/01/2017
10/01/2018
PERSONAL& ADV INJURY
$ 1,000,000
GEN'LAGGREGATE LIMIT APPLIES PER.
PRO
POLICY JECT LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER.
AUTOMOBILE LIABILITY
EOa accident SINGLE LIMIT
$ 1,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
BODILY INJURY (Per accident)
$
B
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
X AUTOS ONLY X AUTOS ONLY
DT-810-5D974152-TIL-17
10/01/2017
10/01/2018
PROPERTY DAMAGE
Per accident
$
X
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 5,000,000
B
EXCESSLIIAB
CLAIMS -MADE
CUP-BJ590281-17-26
10/01/2017
10/01/2018
AGGREGATE
$ 5,000,000
X DED RETENTION $ 10,000
$
WORKERS COMPENSATION
1 PER H
X STATUTE ER
C
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE [y]
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
4210272
07/01/2018
07/01/2019
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 / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if moms pace is required)
REExhibit Lighting for Fort Collins Museum of Discovery The City of Fort Collins, its officers, agents and employees are included as Additional Insured for
General Liability and Auto Liability as required by written contract with respects to liability arising out of work performed by the named insured.
GtK I II-IL:AI t KULUtK
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Purchasing Dept ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
AUTHORIZED REPRESENTATIVE
Fort Coilins CO 80522-0000
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD