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HomeMy WebLinkAbout480152 FORD AUDIO-VIDEO SYSTEMS LLC - INSURANCE CERTIFICATEClient#: 191 FORDAUD ACORD.CERTIFICATE OF LIABILITY INSURANCE O1103/20103 YY) /03I2013 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(ies) 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 CONTACT Penny Lieber Willis of Oklahoma, Inc. ac°ONri Eat :405 552.4855 aC,Ne: 405 552-4437 211 N Robinson, Suite700 S EWAIL Oklahoma City, OK 73102-7105 ADDRESS: 405232-0651 INSURER(S) AFFORDING COVERAGE NAICIf INSURER A: Hartford Underwriters Insurance 30104 1�� INSURED INSURER B: Hartford Casualty Insurance Corn 29424 Ford Systems, LLC INSURER c: Hartford Insurance Co/San Anton 00914 4800 West Interstate 40 WesAudt Interstate INSURER O: RLI Insurance Company 13056 Oklahoma City, OK 73128-5425 INuRERE: Hartford Fire Insurance Company INSsURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 ADDL'SUBR INSR IWVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MMIDDri LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE EX1OCCUR x 38UENQT4423 2/31/201212/3112013 ' EACH OCCURRENCE $1,000000 AMRENcaTErence REMEO $100000 MEDEXP(Anyone person) $5,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLIDV X PE ROT LOC PRODUCTS-COMP/OPAGG $2,000,000 $ E AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS XN-0WNED NO AUTOS x 38UENQT4422 12/31/2012 12131/2013 EOMaBBIINtlEED1SINGLELIMIT $1,000,000 IX BODILY INJURY (Per person) $ BODILY INJURY (Per accident) 3 PROPERT DDAMAGE$ Per accident 8 B x UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE I 8RHUQT4424 12131/201212/31/201 EACH OCCURRENCE $10000000 H AGGREGATE $10 00O 000 DED I X RETENTION$10000 r I$ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR'PARTNERIEXEOUTIVE OFFICER/MEMBER EXCLUDED? (Mandator, in NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA 38WEQT4421 12/31/2012 12131/2013 X WCSTATU- OTH- ER E.LEACHACCIDENT $1 000000 E L DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE -POLICY LIMIT $1,000,000 D Instal Floater Transit ILM0702234 12/3112012 12/31/2013 Limit$5,000,000 Limit $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Ford AV Job #1104361 - The City, its officers, agents and employees are additional insureds in regards to the Lincoln Center Canyon West Audio/Video project. City of Fort Collins PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rii rocorvnd ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S298917/M297902 1JWIL