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Home My WebLink AboutAXIS NETWORKS - INSURANCE CERTIFICATEDate: 1/5/2004 Time: 4:18 PM To: James B. O'Neill II @ 1-970-221-6707 Page: 001-002 ACORQ CERTIFICATE OF LIABILITY INSURANCE 01/055/2004 PRODUCER (303)824-6600 FAX (303) 370-0118 Moody Insurance Agency, Inc. 3773 Cherry Creek North Drive Y Suite 800 Denver, CO 80209-3804 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 Axis Networks, Inc. 4SS W 115th Ave., #3 Northglenn, CO 80234 INSURER A. American States Insurance Co 19704 INSURER INSURER INSURER D. INSURER E: 1i 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 ADD1 NM TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTNE DATE IMMIDDIM POLICY EXPIRATION DATE [MMIDDNYI LIMITS GENERAL LIABILITY 010E9193702 12/21/2003 12/21/2004 EACH OCCURRENCE $ 1,000,00 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE OCCUR MED EXP (Arty one person) $ 10 QQ A X Per Loc Agg PERSONAL & ACV INJURY $ 1, QQQ, QQ X Bl kt Addtl Insd GENERAL AGGREGATE $ 2,000,00( GENE AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGO $ 2,000,00( X POLICY PRO- JECT LOC AUTOMOBILE X LIABILITY ANY AUTO OICG4344781 12/21/2003 12/21/2004 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 A ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NOPLOWNED AUTOS BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY AGG $ ANY AUTO $ EXCESSIUMBRELLALIABILITY OISU32559120 12/21/2003 12/21/2004 EACH OCCURRENCE $ 5,000,00 X OCCUR 71 CLAIMS MADE AGGREGATE $ A $ S,000,00 $ RDEDUCTIBLE X RETENTION $ 10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? 01WC98550520 11/01/2003 11/01/2004 X I roRYU TU- OER MUS E L EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100, 00 I yes, deecnbe under SPECIAL PROVISIONS below E L. DISEASE - POLICY LIMB $ 500,000 OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS e: Bid #5757 Cabling - Fiber Optic & Copper. CFRTIFICATF FI(N nFR ('AMf CI I ATI1111JI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fort Collins EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Administrative Services 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Purchasing Division BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY P.O. Box 580 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Ft. Collins, CO 8OS22-0580 AUTHORIZED REPRESENTATIVE //'J �Gr/Yw Consie Krumreich CISR CAK`-&71"a i ACORD 25 (2001/09) FAX: (970)221-6707 OOACORD CORPORATION 1988 Di--te:'1/5/2004 Time: 4:18 PM To: James B. O'Neill II @ 1-970-221-6707 Page: 002-002 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. s+wr%w Za (cuuirua)