HomeMy WebLinkAbout368014 5280 DIGITAL INC - INSURANCE CERTIFICATE,acoRO CERTIFICATE OF LIABILITY INSURANCE DATE (MM;DD.YYYY)
08/15/2019
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 rights to the certificate holder in lieu of such endorsement(s).
PRODUCER
David Carothers
C/o Praxiom Risk Management, LLC
123 West Bloomingdale Avenue #300
Brandon, FL 33511
INSURED
Nextep. Inc. and Nextep Business Solutions. Inc. Alt. Emp: 5280 Digital Inc
1800 North Interstate Drive
Norman. OK 73072
INSURER B :
INSURER C
(Bea) 350-7729
INSURERS) AFFORDING COVERAGE
FAX
_A.C, Noy..
NAIL 0
40142
INSURER E :
INSURER F: : -1
r`AVCRAf:CS CS:RTIGICATF NIINIRGR•1Q014rnri4od1Q95 RFVICI[1N Nt]URFR'
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 POLICY EFF POLICY Min
LTR TYPE OF INSURANCE POLICYNUMBER D VV rLIMITS
COMMERCIAL GENERAL LIABILM
EACHOCCURRENCE
s
-- -'
`DAMAGE TOi;ENTEO--
CLAIMS MADE _ OCCUR
',, PREMISES (Ea occurrence)
1 S
S
_S
MED EXP (Any one person)
PERSONAL 6 ADV INJURY
I $
GENT AGGREGATE LIMIT APPLIES PER,
GENERAL AGGREGATE
POLICY 'r- j LOC
PRODUCTS-COMP/OP AGG
I S
I $
OTHER:
AUTOMOBILE LIABILITY
COM INI=U 5INUL15 LIMIT is
Es accld
ANY AUTO ICI
BODILY INJURY (Per person) IS
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURV(Per accident) S
_
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PROPERTY DAM%UE
AUTOS ONLY ,_; AUTOS ONLY
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UMBRELLA LIAB OCCUR
EACH OCCURRENCE s
_. _ .
EXCESS LIAB CLAIMS MADE
AGGREGATE
DED RETENTION$
$
:WORKERS COMPENSATION
pp
IRH
STppEE ATUTE E
AND EMPLOYERS' LIABILITY YIN N
_X _1
A 7 NIA WC 56-11-380-06 10810112019 08/01,12020
E.L. EACH ACCIDENT _ _ $ 1,000,000
OFFICERMEMBEREXC UDED9ANYPROPRIETORPARTNEREX�UTIVE
(Mandatory In NM
E.L. DISEASE -EA EMPLOYEE $ 1 .000,000
--
Il yes. describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE POLICY LIMIT S 1 .000,000
Location Coverage Period: 08T112019 08/01i2020
Client* 1495-CO
DESCRIPTION OFOPERATIONS 1 LOCATIONS, VEHICLES (ACORD 101. Additional Remarks Schedule. may be attached it more space Is required)
5280 Digital Inc
Coverage is provided for
7388 S Revere Pkwy Suite 320
only those coerndoyees
of, but not subcontractors Centennial. CO 80112
In:
Endorsements: 30 days written cancel notice It 0 days for non payment of
premium)
City of Fort Collins
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
O 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (201603)
The ACORD name and loco are registered marks of ACORD
2' of 2 339P.