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HomeMy WebLinkAbout480152 FORD AUDIO-VIDEO SYSTEMS LLC - INSURANCE CERTIFICATE (2)Page 1 of 1 A� �® CERTIFICATE OF LIABILITY INSURANCE DA01/02/1 Ol/02/202014 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 endorsemen s . PRODUCER Willis of Oklahoma, Inc. C/o 26 Century Blvd. CONTACT NAME: PHLAIONE ,1-877-945-7378 FA/AC Ne :1-888-467-2378 P.O. Box 305191 E-MAIL ADDRESS: certificatesCeillis.com Nashville, TN 372305191 INSURE S AFFORDNG COVERAGE NAIC # INSURER A: Hartford Fire Insurance Company 19682 INSURED Ford Audio -Video Systems, LLC % INSURER B: INSURER C: 4800 West Interstate 40 48"�rt�/ )52 INSURER D Oklahoma City, OR 73128 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: W152454 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 ADDL SUBR POLICY NUMBER POLICY EFF MMIDD POLICY EXP M LMM GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 x COMMERCIAL GENERAL LIABILITY AMA I ocou N rr $ 300,000 A CLAIMS -MADE X OCCUR NED EXP (Any y one person) $ 10,000 PERSONAL 6 ADV INJURY $ 1,000,000 2048180671 12/31/2013 12/31/2014 GENERAL AGGREGATE $ 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 2,000,000 STOP CAP LIAB $ 1,000,000 POLICY PRa LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A ALL OWNED SCHEDULED AUTOS AUTOS 38 DEN QT4422 12/31/2013 12/31/2014 BODILY INJURY (Per accident) S PROPERTY DAMAGE P raccident $ NON -OWNED HIRED AUTOS AUTOS S A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 10,000,000 AGGREGATE $ 10,000,000 EXCESS LIAR CIAIMS,MADE 3BRBOQT4424 12/31/2013 12/31/2014 DED X RETENTION$10,000 S WORKERS COMPENSATION x( WC STATU- OTH. TORY Ills. A AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? F_N] NIA 38WEQT4421 12/31/2013 12/31/2014 E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS helnw E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Installation Floater 2048180671 12/31/2013 12/31/2014 Limit at temp location: $5,000,000 IT Transit Limit: $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, U more apace Is required) Ford AV Job #1104361 - The City, its officers, agents and employees are additional insureds in regards to the Lincoln Center Canyon vast Audio/Video project. .9119 Le1'1 el ariVAL-AG. 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 City of Fort Collins PO Bor 580 Fort Collins, CO 80522-0000 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SR ID:2049774 BATCH;Batch {i: 19612