HomeMy WebLinkAboutADVANCED CABLING SYSTEMS LLC - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
(MWDDNYYY
DATE
9/5/2014 )
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
Stephens Insurance, LLC
PO Box 3507
Little Rock AR 72203-3507
CONTACT Kimberley Sweet
FAX (501)377-2970
PHONE . (800) 643 - 96 91 IC
EMAIL ,kimberley. eweetRstepheas. com
INSURERS AFFORDING COVERAGE
NAIC9
INSURERA:Valley Forge Insurance Company
0508
INSURED
Advanced Cabling Systems, LLC
4950 Northshore Lane
North Little Rock AR 72118
INSURERB:State Auto Property and
25127
INSURER C:Continental Casualty Company
0443
INSURERD:ROCk:hill Insurance Company8053
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 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
ADDLSUBR
POLICY NUMBER
POLICY EFF
IMMIDDJYYYYJ
POLICY EXP
IMMIDDNYYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAdMAGE TO RENTED
PREMISES (Ea.ccummcal
$ 300,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE FT OCCUR
5095924325
/8/2019
/8/2015
MED EXP (My oneperson)
$ 51000
PERSONAL S ADV INJURY
$ 11000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
X POLICY
PRO LOC
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMITlEa
11000,000
BODILY INJURY (Per person)
$
B
ANY AUTO
ALL OWNED SCHEDULED
AUTOS AUTOS
AP 2389388 Ol
/8/2019
/8/2015
I
BODILY INJURY (Per amden)
tAUTOS
$
NON -OWNED
HIRED AUTOS
PROPERTY DAMAGE
(Per accident
$
Medical Ex se
$ 5 000
X
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$ 51000,000
AGGREGATE
$ 51000,000
L.
E%CESS LIAR
CLAIMS -MADE
DED X RETENTION$ 10,00
$
095924311-01
/8/2014
/8/2015
A
WORKERS COMPENSATION
YbC STATU- OTH-
ANDEMPLOYERS'IIABILITY YIN
ANY PROPRIETORJPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
(Myandatory In NH)
If es. describe under
N I A
5095924308
/8/2014
/8/2015
LIM
E.L. EACH ACCIDENT
$ 1 000 000
E.L. DISEASE - EA EMPLOYE
$ 1,000,000
E.L. DISEASE -POLICY LIMIT
It 1,000,000
DESCRIPTION OF OPERATIONS gel
10
SORU000164-01
/8/2014
/8/2015
DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required)
If required by written contract, Certificate Holder is named as Additional Insured with respects to
General, Auto d: Umbrella Liability Coverage.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
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
ACORD 25 (2010105)
Harbour/SwKI
01988.2010 ACORD CORPORATION. All rights reserved.
INS025 (201005).01 The ACORD name and logo are registered marks of ACORD