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HomeMy WebLinkAbout551369 BACKBONE FIBER SYSTEMS LLC - INSURANCE CERTIFICATE (2)BACKFIB-02 MHOFF F LIABILITY INSURANCE DATE(MM/DD/YYYY) 4/30/2019 ION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES INSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED .DER. ED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. tions of the policy, certain policies may require an endorsement. A statement on eu of such endorsement(s). CONTACT Barb Arnold AME: (A"C, No, Ext): (303) 252-3761 (AA/C, No): (866) 243-0727 E-MD IE : Barbara.arnold@hubinternational.com INSURERS AFFORDING COVERAGE NAIC # INSURER A: United Fire & Casualty 13021 INSURER B:PInnacol Assurance Company 41190 INSURER C : INSURER D : INSURER E : INSURER F : 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPITR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [X] OCCUR X X 60423554 12/1/2018 12/1/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED nte PREMISS fEa $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: � PRO- LOC JECT u OTHER GENERAL AGGREGATE $ 2,000,000 PIPOLICY PRODUCTS 2,000,000 $ $ A AUTOMOBILE LIABILITY ANY AUTO OWNED EX SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY X X 60423554 12/1/2018 12/1/2019 COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Perperson) $ BODILY INJURY Per accident $ X PROPERTY DAMAGE Per. accident $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 60423554 12/1/2018 12/1/2019 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YEN ((Mandatory inNHREXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below NIA X 164180 5/1/2019 5/1/2020 X PER OTH- TATUT R E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE 1,000,000 $ E.L. DISEASE - POLICY LIMIT 1,000,000 $ I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Renewal 8096 Fiber Optic Splicing & Related Services City of Fort Collins is included as additional insured under General Liability and Automobile Liability. City of Fort Collins 215 North Mason Street, 2nd Floor P.O. BOX 580 Fort Collins, CO 80522-0580 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) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD