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127569 FRONT RANGE INTERNET INC - INSURANCE CERTIFICATE
Client#: 41544 FRINT TE ACORD CERTIFICATE OF LIABILITY INSURANCE D2/04/2IDDIYYYV) /oa/zola 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). NTACT PRODUCER NAME: Rosemary Kisling _ Flood & Peterson Ins., Inc. PNDNE 970 266-7158 FAX 9705066845 AIC No Ext : IA/C No): P. O. Box 578 E-MAIL ADDRESS: Greeley, CO 80632 INSURER(S) AFFORDING COVERAGE I NAIC q 970 356-0123 Chuhh Grnun of Innnranca Cmmnan INSURED INSURERB: Plnnacol Assurance Front Range Internet, Inc. I .Z % / n 3350 Eastbrook Drive f D 7 INSURERC: INSURER D Fort Collins, CO 80525 INSURER E INSURER 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. LTRR TYPE OF INSURANCE NSRADDLSUBR WVO POLICY NUMBER MMIDDY EF POLICY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_X] OCCUR 35784775WCE 11/01/2013 11/0112014 EACHOCCURRENCE$1 OOO OOO PREMISES Ea occunence $1 000 000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $ 0 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- LOC PRODUCTS-COMP/OP AGG $1,000,000 $ A AUTOMOBILELIABIUTY ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS is AUTOS IX 1374970114 11/0112013 1110112014 ELIMIT (Ea 1,000,000 BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ PROPERTYDAMAGE$ Per accident a A X1 UMBRELLA LWB EXCESS LL48 J( OCCUR CLAIMS -MADE 93631904 11/01/2013 11/01/201 EACH OCCURRENCE $1 000 000 AGGREGATE $1 000 000 DED RETENTION$WC $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YI N OFFICER/MEMBER EXCLUDED? F—Y] (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4054468 3/01/2014 03/01/201 OTH- X TORYU ITS ER E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEEI $5010000 E.L. DISEASE - POLICY LIMIT 1 $500 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) ** Workers Comp Information ** Other States Coverage Proprietors/Partners/Executive Officers/Members Excluded: William Ward Shawna Killen, Corporate Officer (See Attached Descriptions) City Of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE %I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Director of Purchasing and Risk Management ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserveo. ACORD 25 (2010105) 1 Of 2 The ACORD name and logo are registered marks of ACORD #S861516/M861513 RDK DESCRIPTIONS (Continued from Page 1) Blanket Waiver of Subrogation ** Supplemental Name ** First Supplemental Name applies to all policies - Front Range Internet, Inc. Policy# 35784775WCE - : Eastbrook Ventures, LLC Policy# 35784775WCE - : Vilata Communication, LLC Policy# 35784775WCE - : FRII Wireless LLC - Owns wireless network Policy# 93631904 - : Eastbrook Ventures LLC Policy# 93631904 - : Vilata Communication LLC Policy# 93631904 -: FRII Wireless LLC Certificate holder is included as Additional Insured as required by written contract with respect to liability arising out of work performed by the named insured. SAGITTA 25.3 (2010/05) 2 of 2 #S861516/M861513