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HomeMy WebLinkAbout430295 B W ELECTRIC INC DBA B W SYSTEMS - INSURANCE CERTIFICATEBWSYS-2 OP ID: E1 ,acoRc� CERTIFICATE OF LIABILITY INSURANCEATE 01/26/2017Y) 01/26/2017 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 endorsement(s). PRODUCER Brown & Brown of Colorado, Inc 2170 S. Parker Rd Ste 251 Denver, CO 80231 Jason Sartor CONTACT NAME: EVIe Jo Ontiveros AIC, N Ezt : 720-963-4286 C No): 720-962-5142 E-MAIL ADDRESS: eontiveros@bbdenver.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: Mass. Bay Insurance Co. INSURED B W Electric, Inc. INSURER B : Allmerica Financial Benefit 41840 dba B W Systems 4305 Northpark Dr. Colorado Springs, CO 80907 INSURER C:Pinnacol Assurance Company 41190 INSURER D: Hanover Insurance Company 22292 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 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 INSD SUER WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 X CLAIMS -MADE OCCUR X ZD4-147882-00 02/01/2017 02/01/2018 PREMIET RENTED PREMISES Ea occurrence $ 300,00 X MED EXP (Any one person) $ 10,00 D Prof Liab 02/01/2017 02/01/2018 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY � JEC LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Prof Liab $ 1,000,00 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ B X ANY AUTO X AW4-13147926-00 02/01/2017 02/01/2018 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ X X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ _ $ X H-C Phy Da X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00 D EXCESS LIAB CLAIMS -MADE UH4-D147885-00 02/01/2017 02/01/2018 DED I X I RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRtETOR/PARTNER/EXECUTIVE Y/" OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 4039534 02/01/2017 02/01/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 If yes, describe under DESCRIPTION OF Of ERATIONS below E.L. DISEASE- - POLICY LIMIT $ 1,000,00,. A Lease/Rent 02/01/2017 2/01/2018 Lease/Ren 100,00 A BPP =D4-DI47882-00 7882-00 2/01/20 02/01/2017 2/01/2018 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. CERTIFICATE HOLDER 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 (2014/01) The ACORD name and logo are registered marks of ACORD