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ADVANCED CABLING SYSTEMS LLC - INSURANCE CERTIFICATE (2)
DATE (MM/DD/YYYY) AC R" CERTIFICATE OF LIABILITY INSURANCE 9/10/2018 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 NAME: FeleCla Prince ONE AX Stephens Insurance, LLC (A/C,No,E:t): _�800)852-5053 - (c moi(501)3TT-2470 PO Box 3507 ADDRESS:felecia.prince@stephens.com INSURERS) AFFORDING COVERAGE NAIC 0 Little Rock AR 72203-3507 INSURER AAmerisure Insurance Co an 19488 — _------------ INSURED INSURER B:Navi2torsInsurance Company 42307 Advanced Cabling Systems, LLC INSURERCMillers 4950 Northshore Lane INSURER0: INSURER E : North Little Rock AR 72118 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1891027985 REVISION Nt1MBFR: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISS! IED TO !HE INSURED I ANTED 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 ADUL SUBR I POLICY EFF POLICY EXP TYPE OF INSURANCE LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) -_$___ _ 500, 000* X Contractual Liability X CPP2109841 9/8/2018 9/8/2019 MED EXP (Any one person) $ 15,000 X BCU Not Excluded GEN'L AGGREGATE LIMIT APPLIES PER: PERSONALSADVINJURY $ GENERAL AGGREGATE $ 1,000,000 2,000,000 X POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ _._..$--._ 2,000,000 _ -_...-_.--------- OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) 1,000,000 X ANY AUTO BODILY INJURY (Per person) $ A ALL OWNED SCHEDULED CA2109840 AUUTOSS AUTOS X Per accident) 9/8/2018 9/8/2019 BODILY INJURY . $ ( X X NON -OWNED Hired Auto Ph s Dam HIRED AUTOS AUTOS Y PROPERTY DAMAGE $ (Per accident) - 500 Ded Comp/Coll $ X UMBRELLA LIAB X OCCUR .I, EACH OCCURRENCE i-$_.- _lOtOOO�OOO EXCESS LIAB CLAIMS -MADE AGGREGATE $ 10 000 000 DED RETENTION$ X H018EXC915084IV 9/8/2018 9/8/2019 $ WORKERS COMPENSATION X PER OTH- AND EMPLOYERS' LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1, 000 , 000 OFFICER/MEMBER EXCLUDED? NIA - --- - A (Mandatory in NH) WC2109A42 4/A!201A 9/8/2019 E I_ DISEASE - EA EMPI OYFE $ 1,000,000 If yes, describe under - -- - DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 A Stored Materials CPP2109841 9/8/2010 9/8/2019 Limit of Insurance 500,000 C Professional/Pollution B0621PADVA013018 9/8/2018 9/8/2019 Limit/Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required) Re: Contractors License : AS-2389 If required by written contract, Certificate Holder is named as Additional Insured with respects to General, Auto & Umbrella Liability Coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522-0580 AUTHORIZED REPRESENTATIVE John Harbour/PRFE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)