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Home My WebLink About113132 POWER MOTIVE CORPORATION - INSURANCE CERTIFICATE (2)AGORDTa, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/1 /2019 1 1 1 / 14/2018 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 CONTACT 8110 E. Union Avenue Suite 700 Denver CO 80237 PHONEa/c No Ext : ac No E-MAIL ADDRESS: INSURERI AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A : The Phoenix Insurance Company 25623 INSURED Power Motive Corporation 1438764 5000 Vasquez Blvd Denver, CO 80216 UVSURER B : Travelers Property Casual Insurance Co 36161 INSURER C : Pinnacol Assurance Company 41190 INSURER D : 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYYI POLICY EXP (MMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Ex X Y N Y-660-OK258364-PHX-18 12/1/2018 12/1/2019 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMI E Ea occurrence 300OOO MED EXP (Any oneperson)5 OOO PERSONAL & ADV INJURY $ 1000 000 GENT. AGGREGATE LIMIT APPLIES PER. }( POLICY❑ PROJEC ❑ LOC OTHER. GENERAL AGGREGATE $ 2,000 000 PRODUCTS - COMP/OP AGG $ 2,000,000 1 $ g AUTOMOBILE LIABILITY ANY AUTO AUTOSONLY WNED SCHEDULED AUTOS AUTOS ONLY X NON-OWNED ONLDY Y N 810-1L385426-18-14-G 12/1/2018 12/l/2019 Ee aBINEDI SINGLE LIMIT $ I,000 OOO BODILY INJURY (Per person) $ XXXXXXX Ix BODILY INJURY (Per accident $ XXXXXXX PROPERTY DAMAGE AGE $ XXXXXXX $ XXXXXXX lj X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N CUP-OK270003-18-14 12/1/2018 12/1/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED RETENTION $ $ XXXXXXX L WORKERS C AND EMPLOYOERS' MPENSATION LIABILITY YIN OFFICER/MEM ER EXCLUDED? ANY PROPRIETOR/PARTNERIEXECUTIVE N❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A N 4055198 10/1 /2018 10/1 /2019 X I STATUTE DER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE- EA EMPLOYEE 500,000 E.L. DISEASE - POLICY LIMIT is 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / 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. CERTIFICATE HOLDER CANCELLATION See Attachments 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 ACORD 25 (2016/03) @ 1988-2015 ACORb CORP RATION. All rights reserved The ACORD name and logo are registered marks of ACORD