The URL can be used to link to this page

Home My WebLink About124503 SAGE TELECOMMUNICATIONS CORP - INSURANCE CERTIFICATEACORD, CERTIFICATE OF LIABILITY INSURANCE OPID f DATE(MMIDD/VYYY) CoBiz Insurance, Inc. 10901 W Toller Dr, Ste 200 �tleton CO 80127 .,Dne:303-988-0446 Fax:303-988-0804 Sage Telecommunications Corp of Colorado, LLC 5790 Eudora Street Commerce City CO 80022 vw T SAGE-1 1 02/20/08 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 # INSURER A. First Mercury Insurance Cc INSURERB: Allied Insurance NSURERC: AIG INSURER D: Pinnacol Assurance INSURER E: 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. jTTNSRAEFDPGllO�FE�'i TYPE OF INSURANCE POLICY NUMBER DATE(MMIDD/YY �EXP1q I DATE MM/DDIYY LIMITS rLTRNS GENERAL LIABILITY iX1COMMERCIAL GENERAL LIABILITY J CLAIMS MADE IX OCCUR —I — FMTX001453 03/01/08 03/01/09 EACH OCCURRENCE S1,000,000 PREMISES(Ea oCcurence) S50,000 MED EXP (Any one person) S5,000 'PERSONAL &AUV INJURY _ 51, 000, 000 j _J rNLRAL AGGREGATE ODUCTS - COMPIOP AGO S2,000,000 S2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECOT 1-1 LOG np Ben. 1, 000, O00 B AUTOMOBILE X jx LIABILITY ANY AUTO ALLOWNEDAUTOS SCHEDULEDAUTOS HIREDAUTOSD NON -OWNED AUTOS ACP7503147151 03/01/08 03/11/09 COMBINED SINGLE LIMIT (Ea acadenD BODILY INJURY (Per person) 51i 000, 000 5 INJURY (Perer acc a<citlenl) S XI1 PROPERTY DAMAGF (Per accitlenp 1 S ^, G GARAGE^LIABILITY ANY AUTO j AUTO ONLY - EA ACCIDENT S OTHER THAN _EA ACC AUTO ONLY: AGG S S C EXCESS/UMBRELLA LIABILITY X OCCUR I�CLAIMS MADE DEDUCTIBLE X RETENTION $10, 000 BE9039634 03/01/08 03/01/09 EACH OCCURRENCE S 5,000,000 AGGREGATE S5,000,000 S S S D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICEFUMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4098791 03/01/08 03/01/09 OTH- X TORY LIMITS ER E.L. EACH ACCIDENT 5I 000 000 , , E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE -POLICY LIMIT SI, 000, 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS UtN I IYIUAI t HULUtH rAMCPI I ATInM TOWHOMI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYSWRITTEN TO Whom It May Concern 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 REPRESENTATIVES, AUTHORI RESENTA HUURU 40 (LVUIIvo) © ACORD CORPORATION 1988 WORKERP COMPENSATION EXPERIENCE HATING SAGE TELECOMMUNIL IONS CORP OF COLORADO LLC NAME EFFECTIVE DATE 01/01/08 OF RISK RISK (DENT. NO 911419009 R STATE 11N I C K C I A l t 1 2 3 4 EXP EXC S EXPECTED N EXP PRIM' ACT EXC 8 ' ACT INC 10 ACT PRIM STATE III SRP LOSSES LOSSES LOSSES LOSSES BALLAST LOSSES LOSSES CO 020 1450I 87801 109578 21777 0 29000 1231 1231 OR 016 1365 39188 52289 13101 0 29975 283 283 UT 026 920 0 0 0 0 25900 0 0 RATING REFLECTS A DECREASE OF 70% MEDICAL ONLY PRIMARY AND EXCESS LOSS DOLLARS WHERE ERA IS APPLIED **** :kREVISED RATING * �* E AIRAP FACTORI SHOWN IS IFOR THOSE ISTATES CONTAINED GIN THIS TINIG THAT HAVE APPROVED THE ARAP PROGRAM AND IS CALCULATED SEDI ON THE STATE !l1ITH TIHE HIGHEST APPROVED MAXIMUM ARAP RCHIARGE THE .1AXIMUM ARIAP SURCHARGE MAY VARY BY STAITE PILEASE REFEIR TO EACH STATES APPROVED RULES FOR THE APPILICABLESMAXIMUM ARAP SURCHARGE. RATTING ;REV (ARAPI) IF IAPPLI : 1 00 1 ISARAP: 0 �(A) W) i(C) EXPECTED '(0) (E) (P) ACTUAL (GI IHI (1) EXCESS EXCESS (D E) (H-1) �019 ; 26989161867 34878 0 293t5 653 653 local by Polpcy Year of all Cases $2.000 Dr lass. Ir.led loss. 1111 PRIMARY (121 STABILIZING 1131 RATABLE IT C:la slrO pFIC loss. LOSSES VALUE EXCESS 114) TOTALS O Disease L E "....... Li mab11111Y Lo55. PAGE NUMBER 000 DATE 12/05/07 I151 EXP.MO2 �iJI / INI� 0 69 s COPYRIGHT, (993-2006. ALL RIGHTS RESERVED IF IF THIS EXPERIENCE MODIFICATION FACTOR IS COMPRISED OF COMPILATIONS AND INFORMATION WHICH ARE THE DROPRIETARY AND EXC- L USIVE PROPERTY OF NCCNO FURTHER USE.DISSEMINATION. SALEc TRANSFER. ASSIGNMENT OR DISPOSITION OF THIS EXPERIENCE MOOIFICATION 'ACTOR OR PANY PART HEREOF MAY 3E MADE WITHOUT THE WRITTEN CONSENT OF NCCL NCCI MAKES NO REPRESENTATION OR WARRANIY.EXPRESSEO OR IMPLICD.AS TO ANY MA1TEfl WHATS OE VC-R INCLUDING BUT NOT LIMITED TO THE ACCURACY OF ANY INFORMATION . PRODUCT OR SERVICE FURNISHED HEREUNDER AND. AS 10 NCCI. Jill (C) X 11Vs H IGI IAI F I'll IJI ACTUAL i 653 - 132176 0 132829 -_" I ElIA1 X ICI IKI ;EXPECTED 34878 132176 24128 191182 RECIPIENT OF THIS EXPERIENCE MODIFICATION FACTOR SUISCRIBES TO AND UTILIZES THE INFORMATION SERVICE "AS IS". 004234/000003105010