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Home My WebLink About520763 AMBIENT ENERGY INC - INSURANCE CERTIFICATEClient#: 1082362 AMBIEENE ACORD, CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/DD/YYYY) 4/05/2019 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: US[ Insurance Services, LLC 800 873-8500 P.O. Box 7050 (A/C, No, o, EXt), (A/c, No): E-MAIL Englewood, CO 80155 ADDRESS: — - 800 873'8500 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Hartford Casualty Insurance Company 29424 INSURED Ambient Energy, INSURER B : Hartford Accident & Indemnity Company 22357 INSURER C : Liberty Insurance Underwriters, Inc. 1449 7th Street, Suit440 19917 Denver, CO 80204-8898 INSURER D 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 CONTRACTOR 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. pR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER _ _ _ 34SBWPG4483 POLICY EFF MM/DD/YYYY I POLICY EXP LIMITS $2000,000 A �( COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ". OCCUR __(MM/DD/YYY 4/01/2019'04/01/202 EEDACHOCCURRENCE PREMISES0Ea RENTED $1 000,000 MED EXP (Any one person) $10 000 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � JECOT -I LOC GENERAL AGGREGATE $4,000,000 PRODUCTS - COMP/OP AGG $4,000,000 $ _ OTHER: A AUTOMOBILE LIABILITY 34SBWPG4483 4/01/2019 04/01/202 CMINED Ea accden SINGLE LIMIT 2,000,000 BODILY INJURY (Per person) $ ANY AUTO SCHED AUTOS ONLY AUTOSULED HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident)$ $ A X UMBRELLA LIAB X OCCUR 34SBWPG4483 4/01/2019 04/01/2020 EACHOCCURRENCE $1 000000___ AGGREGATE $1 00O 000 EXCESS LIAB CLAIMS -MADE DED X' RETENTION $10000 PER OTH- X $ 4/01/2019 04/01/202 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A _ 34WEGVY3870 E.L. EACH ACCIDENT $1 OOO OOO _ E.L. DISEASE - EA EMPLOYEE $1 000 000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1.000.000 C Professional AEXNYABGEBY002 4/01/2019 04/01/2020 $2,000,000 per claim Liability F� $2,000,000 annl aggr. Claims Made DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) As required by written contract or written agreement, the following provisions apply subject to the policy terms, conditions, limitations and exclusions: The Certificate Holder and owner are included as Automatic Additional Insured's for ongoing and completed operations under General Liability; Designated Insured under Automobile Liability; and Additional Insureds under Umbrella/Excess Liability but only with respect to liability arising out of the Named Insured work performed on behalf of the certificate holder and owner. (See Attached Descriptions) City of Fort Collins Purchasing Dept. PO 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 ACORD 25 (2016/03) 1 Of 2 #S25412342/M25411663 01988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD P1 DZP