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HomeMy WebLinkAbout430295 B W ELECTRIC INC DBA B S SYSTEMS - INSURANCE CERTIFICATEBWSYS-2 OP ID: E1 ' Ili- CERTIFICATE OF LIABILITY INSURANCE `--�� DATE (19/2 Y8 01 /19/2018 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 CONTANAME: CT Evie Jo Ontiveros PHONE FAX A c No Exc : 720-963-4286 A/c No): 720-962-5142 E-MAIL -M IIEss: eontiveros@bbdenver.com Denver, CO 80231 Jason Sartor - 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. NOI-WITHSTANDiNG 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 SUB WV POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE a OCCUR X ZD4-147882-01 02/01/2018 02/01/2019 DAMAGE TO RENTED PREMISES Ea occurrence $ 300,00 X MED EXP (Any one person) $ 10,00 D Prof Liab 02/01/2018 02/01/2019 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY X JE LOC PRODUCTS -COMP/OP AGG $ 2,000,00 Prof Liab $ 1,000,00 OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ B X ANY AUTO X AW4-D147926-01 02/01/2018 02/01/2019 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED X HIRED AUTOS X AUTOS $ 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-D147885-01 02/01/2018 02/01/2019 DED X RETENTION $ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? _N (Mandatory in NH) N / A 4039534 02/01/2018 02/01/2019 X PER OTH- STATUTE I ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE _ $ 1,000,00 - If yes, describe under DESCRIPTION OF OPERATIONS below_ E.L. DISEASE -POLICY LIMIT $ 1,000,00 02/01/2019 Lease/Ren 100,00 A Lease/Rent ZD4-D147882-01 02/01/2018 A BPP ZD4-D147882-01 02/01/2018 02/01/2019 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 CANCELLATION CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins PO Box 580 AUTHORIZED REPRESENTATIVE V �, 6570 Portner Road Fort Collins, CO 80522-0580 C J 8J © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD