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HomeMy WebLinkAbout486364 INTEGRA TELECOM INC - INSURANCE CERTIFICATE (3)AFRO® CERTIFICATE OF LIABILITY INSURANCE DA DIYYVY) 12/09/2I09I2013 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 endorsements). PRODUCER McGri6, Sabi & Williams Of Oregon 1800 SW First Avenue, Suite 400 CONTACT NAME: PHONE AI o , 503-943.6621 1503443.6622 E-MAIL ADORESS: Portland, OR 97201 INSUREIII AFFORDING COVERAGE NAIC E INSURER Alui Specialty Insurance Company 27154 INSURED Integra Telecom, Inc. / INSURER B : INSURER C: NE Lloyd Boulevard FV� 11./, �/ �� Suit Suite 500 Portland,OR 97232 INSURER o INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:JX8GW77V 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 MAYBE 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. IPOLICY LTR TYPE OF INSURANCE POLICY NUMBER MaliFF EXP MMIDDIYYYY LIMITS A GENERAL UABIUTY 711-00-91-49-0007 12/15/2013 12/15/2014 EACH OCCURRENCE E 1,000.000 PREMISES Me owunence E 500,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE aOCCUR NED EXP(A one person) E 10,000 PERSONAL &AD✓INJURY E 1.000,000 GENERAL AGGREGATE E 2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AOG E 2,000,000 POLICY PRO- X LOC E A AUTOMOSILELIABILITY 12/152013 121152014 Ea ecGdm 11000,000 X BODILY INJURY (Per person) E ANY AUTO ALL WANED SCHEDULED AUTOS BODILY INJURE (Per ModelE Per welders)E HIRED AUTOS AUUTNOS f UMBRELLA LIAR OCCUR EACH OCCURRENCE S AGGREGATE f EXCESS UAB czccM:-MADE DED I I RETENTIONS f WORKERSCOMPENSAni A - - AND EMPLCYERS'LU\BILITY YIN L E.EACH ACCIDENT E ANY PROPmETOP1R1mNERlE%ECUTVE OFFICERflil ER EXCLUDED9 NM E.L. DISEASE - EA EMPLOYEE E (Mandatory In Ni If r deamce under DESCRIPTION OF OPERATIONS Isam, E.L. DISEASE -POLICY LIMIT f f S S S DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mom space is meuimd) 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 wntract subject to policy terms, Conditions, limits and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATETHEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins AUTHORIZED REPRESENTATIVE �1 PO Box 580 1 , c A,� Fort Collins, CO 80522 0 Page 1 of 1 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 26 (2010105) The ACORD name and logo are registered marks of ACORO A� �® CERTIFICATE OF LIABILITY INSURANCE ° 12109/20113 Y' 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, ANDTHE 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 endomement(s). PRODUCER McGriff, Seibels 8 Williams of Oregon 1800 SW First Avenue, Suite 400 CONTACT NAME: PHONE d Ext : FAX No.tic N, : 503-943.6622 E-MAIL ADDRESS: Portland, OR 97201 INSUREIi AFFORDING COVERAGE NAIC0 INSURER A:AganScSpecialty Insurance Company 27154 INSURED Integra Telecom, Inc. INSURER B: 1201 NE Lloyd Boulevard MSURERC : Suite 500 Portland, OR 97232 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER:20CG92CD REVISION NUMBER: THIS ISM 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. ILTR TYPE OF INSURANCE POUCYNUMBER MM0DrYVYY MMNDIYYVY LIMITS A GENERAL UABILITY 711-00-91-49-0007 1W 5/2013 12J1512014 EACHOCCURRENCEE 1,000,000 X COMMERCIAL GENERAL LABILITY PREMISES Es commerce $ 500,000 CLAIMS -MADE Fx] OCCUR MED EXP(Any one person) $ 10,000 PERSONAL SAW INJURY E 1,OD0,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 2,000,000 F1 PRO- M $ POLICY LOC A AUTOMOBILE LIABILITY 711-0 A1-49 07 1PJ15/2013 12/15/2014 COMBINED SINGLE UNUT 1.000,000 BODILY INJURY (Per person) $ X ANY AUTO BODILY INJURY(Per accident) $ ALL OWNED SCHEDULED )-ONMED Per accident $ HA RED AtIrOS NONMS AUTOS E UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS DAB CLNMS-MADE DED I I RETENTION$ $ WORKERS COMPENSATION WC STATU. OTH. AND EMPLOYERS' LIABILITY 'YIN ANY PP.OPRIETOWPARTNER,EXECUTNE OFFICE"EMBER EXCLUDED? N/A E.L. EACH ACCIDENT s (Mandalory In NH) E.L. DISEASE - EA EMPLOYEE $ E.L DISEASE -POLICY LIMIT E Ifg desorlbeunder DESCRIPTION OF OPERATION$ below E f E f DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H mom apace is rac ilnd) Re: network services contract 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 OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins PO Box 580 AUTHORIZED REPRESENTATIVE a Fort Collins, CO 80522 Page 1 of 1 © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010J05) The ACORD name and logo are registered marks of ACORD