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HomeMy WebLinkAbout113132 POWER MOTIVE CORPORATION - INSURANCE CERTIFICATEACORD,. CERTIFICATE OF LIABILITY INSURANCE 12/1/2018 DATE(MMIDDIYYYY) 9/24/2018 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 have ADDITIONAL INSURED provisions or 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 Lockton Companies NA TAME FAX A/C No Ext : AIC No): 8110 E. Union Avenue Suite 700 Denver CO 80237 E-MAIL ADDRESS: INSURER AFFORDING COVERAGE N I (303) 414-6000 INSURER A: The Phoenix Insurance Company 25623 INSURED Power Motive Corporation INSURER B : The Charter Oak Fire Insurance Company 25615 1438764 5000 Vasquez Blvd Denver, CO 80216 INSURER C : Travelers Property Casualty Co of America 25674 INSURER D : Pinnacol Assurance Company 41 190 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 15549234 REVISION NUMBER: XXXXXXX 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 TR TYPE OF INSURANCE ADDL IN D SUBR WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE � OCCUR Y N 660OK258364 12/1/2017 12/1/2018 EACH OCCURRENCE 1,000,000 DAMAGE ( RENTED PREMISES Ea occurrence 300,000 MED EXP (Any oneperson) 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: �{ POLICY❑ JERCT❑ LOCO- OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS ONLY SCHEDULED AUTOS AUTOS ONLY X AUUTOS ONE Y N BAOK212780 12/1/2017 12/1/2018 O a INEDtSINGLE LIMIT $ 1 000 000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXX X PROPERTY tDAMAGE $ XXXXXXX $XXXXXXX C X UMBRELLA LIAR EXCESS LIAR X I OCCUR CLAIMS -MADE N N CUPOK270003 12/1/2017 12/1/2018 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10.000.000 DEL) I I RETENTION $ $ XXXXXXX D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N OFFICER/MEMBER EXCLUDED? ECUTIVE N] (Mandatory in NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below N / A N 4055198 10/1/2018 10/1/2019 X STATUTE ER EL EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE 500,000 E L DISEASE - POLICY LIMIT 1 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE; City of Fort Collins is an additional insured on general liability and automobile liability if required by written contract. GtK I IFIGA I t HULUtK GANGtLLA I IUN Jee Attacnments SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 15549234 AUTHORIZED REPRESENTATIVE City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 r% lyl ILA ACORD 25 (2016/03) 119 8 201! ORPOICATION. All rights reserved The ACORD name and logo are registered marks of ACORD