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Home My WebLink AboutQWEST INTERPRISE AMERICA - INSURANCE CERTIFICATE`'�++,,�• m CERTIFICATE NUMBER PRODUCER Marsh USA Inc. The Financial Center 1215 4th Avenue Suite #2300 SEA-000659690-07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN. COMPANIES AFFORDING COVERAGE Seattle, WA 98161-1095 COMPANY Attn: Kathy B. Hariri 206 613-2625 Fax: 206 613-2516 00535-QIA-GAW-05-06 kbh 040206 none A NATIONAL UNION FIRE INS CO OF PA INSURED COMPANY QWEST INTERPRISE AMERICA, INC. 1801 CALIFORNIA STREET, SUITE 1150 B INSURANCE COMPANY OF THE STATE OF PA COMPANY DENVER, CO 80202 C AMERICAN HOME ASSURANCE COMPANY FCOMP ANYY D vp THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MMIDDIYY) POLICY EXPIRATION DATE (MMIDDIYY) LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR IGL6051488 04/01/05 04/01/06 GENERAL AGGREGATE $ 1,000,000 X PRODUCTS -COMPIOP AGG $ 1,000,000 _ PERSONAL&ADV INJURY $ 1,000,000 OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 1,000,000 MED EXP (Any oneperson) $ 5,000 A A AUTOMOBILE LIABILITY ANY AUTO CA2053350(AOS) 04/01/05 CA2053349 (TX) 04/01/05 04/01/06 04/01/06 COMBINED SINGLE LIMIT $ 1,000,000 X A ALL OWNED AUTOS SCHEDULED AUTOS CA2053348(VA) 04/01/05 04/01/06 BODILY INJURY (Per person) $ HIREDAUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X ELF -INSURED FOR X PROPERTY DAMAGE $ UTO PHYSICAL DAMAGE GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: ANY AUTO EACHACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ AGGREGATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM $ A B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC5899586 (AOS) 04/01/05 WC5899585(CA) 04/01/05 04/01/06 04/01/06 X TORYLIMITS ER �')fL(XS;"! MIN EL EACH ACCICENT $ I,CCC,000 A A THE PROPRIETOR/ INCL PARTNERS/EXEC UTIVE OFFICERS ARE: EXCL W WC5899588 (ND OH WI V WY) 04/01/05 WC5899597(OR) 04/01/05 04/01/06 04/01/06 EL DISEASE -POLICY LIMIT $ 1,000,000 EL DISEASE -EACH EMPLOYEE 1 $ 1,000,000 OTHER - C Excess Workers' Compensation WC5899589 (WA) 04/01/05 04/01/06 SIR Each Accident/Employee $1,000,000 Excess of SIR Shawn Above $1,000,000 DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS RE: Backup for City on Nortel equipment maintenance (4/2/05 to 4/2/06). The City, its officers, agents and employees are Additional Insureds as respects their interest in the operations of the Named Insured as required by written contract regarding General Liability. L £g tc _,.vr, t.: �x, ;' § .€ ':it4 SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, City of Fort Collins Attn: Jeri Mael THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL _g0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR PO BOX 580 Fort Collins, CO 80522 LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, IT AGENTS OR REPRESENTATIVES. OR THE ISSUER OF THIS CERTIFICATE. MARSH USA INC. �` BY: Cheryll L. Koch UL.l,GG�(, y�j adA _ iq g §••', .• - �} VALID AS OF: 03/30/05 - ,li.