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Home My WebLink AboutMAXIM TECHNOLOGIES - INSURANCE CERTIFICATEACORD,, CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 10/05�2006 PRODUCER 877-945-7378 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Willis North America, Inc. 26 Century Blvd. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 305191 Nashville, TN 372305191 INSURERS AFFORDING COVERAGE NAIL# INSURED Maxim Technologies, Inc. INSURERA: ACE American Insurance Company 22667-012 721 S Packard Kansas City, KS 66105 INSURERB:American International Specialty Lines In 26883-001 INSURER C: INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR &DD'L rypEOFINSURANCE POLICYNUMBER POLICY EFFECTIVE POLICY EXPIRATION UMW A GENERAL LIABILITY EDOG2059214A 10/1/2006 10/1/2007 EACHOCCURRENCE $ 1,000,000 ][ COMMERCIAL GENERAL LIABILITY CLAIMS MADE ® OCCUR pRE IMSES EaEoNcaurenw $ 1,000,000 MED EXP(Any one person) $ 100,000 PERSONAL&ADV INJURY $ 11000,000 X Contract Liab. X K,C,U Coverage GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY FX7 PRO- JFCT X LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILYINJURY (Per person) $ ALLOWNEDAUTOS SCHEDULEDAUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Pereccident) $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ OTHERTHAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESS LIABILITY XOOG23714966 10/1/2006 10/1/2007 EACHOCCURRENCE $ 5,000,000 X7 OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 $ RDEDUCTIBLE $ X RETENTION $ OD A A WORKERS COMPENSATION AND EMPLOYERS'LIANUTY ANY PROPRIETOR/PARTNER/EXECUTIVE AOS WLRC44465279 WI SCFC44465280 10/l/2006 10/1/2006 10/1/2007 10/1/2007 g I T"o'Ry"UmlYi; OTH- E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE -EA EMPLOYEE $ 1 DOO 000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1 0Q 000 H OTHER 1952583 10 1 2006 10 1 2007 $5,000,000. Each Claim Prof.Pollution Legal Liab $5,000,000. Aggregate Contractors Pollu.Liab $ 250,000. Retention Claim Nax. Claim durincr policyear DESCRIPTION OF OPERA'KINSA.00ATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS This certificates voids and replaces the certificate issued on October 2, 2006. All States Covered, except Only "Stop Gape in OR, ND, WA, WV, WY, PR, USVI CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Fort Collins REPR E TI AU P.O. Box 580 Fort Collins, CA 80522/,� ACORD 25 (2001/00) Coll:1765896 Tpl:549428 Cert:7895b78 CACORDtORPORATION1988 Page 2 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD25(2001I08) Co11:1765896 Tp1:549428 Cert:7895878 ACORD. CERTIFICATE OF LIABILITY INSURANCE page 1 of 2 TE 10/05/2006 PRODUCER 877-945-7378 Willis North America, Inc. 26 Century Blvd. P. 0. Box 305191 Nashville, TN 372305191 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Maxim Technologies, Inc. 721 S Packard Kansas City, ES 66105 INSURERA: ACE American Insurance Company 22667-012 INSURERS: American International Specialty Lines In 26083-001 INSURER C: INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD'L TYPE OF INSURANCE POLICYNUMBER POLICYEFFECTIVE POLICYEXPIRATION LIMA A GENERAL LIABILITY HDOG2059214A 10/l/2006 10/1/2007 EACHOCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [i] OCCUR PREMISESMa RENTED $ 11000,000 MEDEXP(Anyons Person) $ 100.000 PERSONAL& ADV INJURY $ 11000,000 X Contract Liab. X X,C,U Coverage GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2 000 000 POLICY X PRO- X LOC AUTOMOBILE LIABILITY ANY AUTO _ COMBINED SINGLE LIMIT (Ee accident) $ BODILYINJURY (Per person) $ ALLOWNEDAUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Peraccident) $ GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ OTHERTHAN EAACC $ ANYAUTO $ AUTO ONLY: AGG A EXCESS LIABILITY XOOG23714966 10/l/2006 10/1/2007 EACHOCCURRENCE $ 5,000,000 X7 OCCUR CLAIMS MADE AGGREGATE $ 5,000,000 $ PDEDUCTIBLE - $ X RETENTION $ 50.00( A A WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE ADS WLRC44465279 WI SCFC44465280 10/1/2006 10/1/2006 10/l/2007 10/1/2007 X wcsTATT- E.L. EACH ACCIDENT $ 1,000,600 E.L. DISEASE -FA EMPLOYEE $ 11000,000 OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 11000,000 H OTHER 1952583 10/l/2006 10 1 2007 $5,000,000. Each Claim Prof.Pollution Legal Liab $5,000,000. Aggregate Contractors Pollu.Liab $ 250,000. Retention Claim IN . Claim during lic ea DESCRIPTION OF OPERATIONS/LOCATI)NSA/EHICLESIEXCLUSIONS ADDED'BY ENDORSEMENT/SPECIAL PROVISIONS This certificates voids and replaces the certificate issued on October 2, 2006. All States Covered, except Only "Stop Gap" in OR, ND, WA, WV, WY, PR, USVI CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Fort Collins REPR E 71 AUTH P.O. Box 580 Fort Collins, CO 80522 _ /. a� ACORD 25 (2001/08) Coll:1765896 Tpl:549428 Cert:7895$77 ®ACORDrORPORATION1988 Page 2 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 25(2001/081 Co11:1765896 Tn1:549428 Cart:7895877