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HomeMy WebLinkAboutCalix, Inc - Insurance Certificate ,�►co O® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12120/20, THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLI BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHOR 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 CONTACT WS Certificates &Co. ao o FAX,844-972-632650 California Street, Floor 12 A/C No): San Francisco CA 94111 ADDRESS: Certificates@woodruffsawyer.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: Hartford Fire Insurance Company 19682 INSURED CALIINC-01 INSURER B:Trumbull Insurance Company 27120 Cal ix, Inc. 2777 Orchard Parkway INSURER C:Sentinel Insurance Company,Ltd. 11000 San Jose, CA 95134 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:937148333 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 I ADDLSUBR EFF LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDDIYYYY MMIDDY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y 57UUNBG60UP 11/30/2024 11/30/2025 EACHOCCURREN DAMAGE TO RENTED CE $1,000,000 _l CLAIMS-MADE OCCUR PREMISES Ea occurrence $1,000,000 MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 2,000,000 _ Fy PRO- POLICY JECT I LOC PRODUCTS-COMP/OP AGG $2,000,000 OTHER: $ B AUTOMOBILE LIABILITY Y 57UENBB9924 11/30/2024 11/30/2025 Ea BINEDtSINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY AUTOS ONLY AUTOS (Per accident) S HIRED NON-OWNED X AUTOS ONLY X AUTOS ONLY PROPERTY DAMAGE $ -, �. Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ C WORKERS COMPENSATION 57WEAA80UZ 1/1/2025 1/112026 X PER OTH- AND EMPLOYERS'LIABILITY Y/N I STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBEREXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) The City of Fort Collins,its officers,agents,and employees are included as additional insured as respects General Liability and Auto Liability to the extent provided in the attached forms. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Purchasing Division PO. Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 4v if I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD