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Home My WebLink About632078 LOGIC INTEGRATION LLC - INSURANCE CERTIFICATEACOR" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/VYYY) 11/29/2018 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 NAME: Brianne Danielson, CISR PHONE Exfl(970)266-7118 AC No: (970)506-6846 Flood and Peterson AIL ADDRESS:BDanielson@floodpeterson.com Corporate Mailing Address: INSURERS AFFORDING COVERAGE NAIC # P.O. BOX 578 INSURER A:Firemens Ins. Co. of Washington, DC 21784 Greeley CO 80632 INSURED INSURER B : Pinnacol Assurance 41190 INSURERC: Logic Integration, LLC INSURER 0: 8224 Park Meadows Drive INSURER E : INSURER F : Lone Tree CO 80124 COVERAGES CERTIFICATE NUMBER:CL1812421712 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. INSRPOLICY LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER EFF MMIDD/YYYV POLICY EXP MM DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE ❑X OCCUR DAMAGE TO RENTE PREMISES (Ea o currence) $ 300,000 MED EXP (Any one person) $ 10,000 X CPA3010161-28 1/12/2018 1/12/2019 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMITAPPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY a PRO- F LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X CPA3010161-28 1/12/2018 1/12/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED X HIRED AUTOS X AUTOS X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 N AGGREGATE $ 5,000,000 A EXCESS LIAR CLAIMS -MADE DED I X I RETENTION 0 $ CPA3010161-28 1/12/2018 1/12/2019 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER (Mandatory EXCLUDED) N❑ (Mandatory in NH) N / A 4161686 2/1/2018 2/1/2019 PER OTH- X TAT TE R E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. CERTIFICATE HOLDER CANCELLATION City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 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 B Danielson, CISR/BDA y3t'o�sGl2nte[wn . n 19RR_9n'Id ArORn rOPPORATInN All rinhtc ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)