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HomeMy WebLinkAbout486364 INTEGRA TELECOM INC - INSURANCE CERTIFICATEACORO® CERTIFICATE OF LIABILITY INSURANCE DAT2/12/2011 tvlvzoll THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. - - -- - - IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must 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 MCGnl Seibels 8 Williams of Oregon 1800 SW First Avenue, Suite 400 ONTACT -NAME: FAX N . 503-943-6621 AIc No 503-943-6622 E-MAIL ADDRESS: Portland, OR 97201 INSURERS AFFORDING COVERAGE NAIC # INSURER A:Onebeamn America Insurance Company 20621 INSURED I I Q 11 Integra Telecom, Inc.- INSURER B: INSURER C: 1201 NE Lloyd Boulevard Suite 500 Portland, OR 97232 INSURER D: INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:DX8D3JVr 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 LTR TYPE OF INSURANCE ADDLSUBIR POLICY NUMBER POLICY EFF MMMDIYYYY POUCYEXP MMIDD LIMITS A GENERAL LIABILITY 711-00-91-49-0005 12/15/2011 12/15/2012 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 500,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 7 OCCUR MED EXP (Any one parson) $ 10,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ '2,000,000 POLICY JECT " X LOC S A AUTOMOBILE UABILITY - 711-00-9149-0005 12/15/2011 12/15/2012 COMBINED SINGLE LIMIT Ea accident 1. 000,000 X BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 1HIRED BODILY INJURY(Per accident) $ PROPERTY DAMAGE Perecvident $ NON -OWNED AUTOS AUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED I I RETENTION$ $ WORKERS COMPENSATION I WCSTATU- OTH- AND EMPLOYERS' LASILRY Y I N E.L. EACH ACCIDENT $ ANYPROPRIETOR/PARTNERIEXECUTIVE OFF'EXCLUDED? NIA NIA E.L. OISEASE- EA - EMPLOYEE IMnnd.l, in NH) U$ eS, de3IXlbe under SCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ S S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (AHach ACORD 101,AddlOonal RemeHle Schedule, if more space Ie rayelred) Re: City of Fort Collins BID 7176 "Telephone Lines for City of Fort Collins" Certificate Holder is named as an Additional Insured as respects the operations of the Named Insured with respects to General and Auto Liability coverage as required by written and signed Contract subject to policy terms, Conditions, limits and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORED REPRESENTATWE G PO Box 580 Fort Collins, CO 80522 Page 1 of 1 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD