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HomeMy WebLinkAbout539869 LIGHTFIELD ENTERPRISES - INSURANCE CERTIFICATE (8)1 ® A� � CERTIFICATE � OF LIABILITY INSURANCE DATE(MMIDD/YYYV) 5/19/2020 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. THS-CERTIFICATE F INSU A CONTRACT BETWEEN THE , ISSUING INSURER(S),. AUTHORIZED .- YE T ANDRTNNCEi E CEROT FS RPkES- NOLDERTUTE - - IMPORTANT: `If the -certificate holder is an ADDITIONALIINSURED, 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 ri hts to the certificate holder in lieu of such endorsement(s). -._ PRODUCER _ � The Harry A. Koch Co. P.O. Box 45279 Omaha NE 68145-0279 -- CONTACT__. NAME: PHONE - FAx A/ No Ext 402-861-7600 plc No noDRess: lynn.haugen@hakco.com INSURER ) AFFORDING COVERAGE _ NAICa INSURER A: National Union Fire Ins Co. of Pitt 19445 INSURED LIG46636 INSURER B : New Hampshire Ins Company 23841 Lightfield Enterprises 2600 Midpoint Drive INSURER C: Fort Collins CO 80525 . SURER D : -IN INSURER E: INSURER F : COVERAGES CERTIFICATE NUMBER: 1697993799 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, TERf 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. ILTR NSR TYPE OFINSURANCE. 1=ADDL WVD SUER 1POLICY NUMBER MM/DDNYYCY MMn)DV�YP LIMITS A X CONMERCIALGENERALUA6ILITY . - -. CLAIMS -MADE � OCCUR -Y. .. - _ __ -_— 3506965 ,. .. � �� ...__..__ 6/1/2020 - - - -__ __.. 6/1/2021 -- EACHOCCURrNTE $1,o00,000 �MISE S (RENTED— PREMISES (Ea o¢urrencel _ $ 300,000 MED EXP (Anyone person) $ 25,000 — PERSONAL&ADV INJURY _ S1,000,000 GEN'LAGGREG�AT�E LIMIT APPLIES PER: POLICY I`^J JE a'� LOC-' OTHER.- - _ _ ' GENERALAGGREGATE.- s2,066,000'' ' PRODUCTS-COMP/O_PAGG $2,000,000 _ Is A AUTOMOBILE LIABILITY- X ANYAUTO GAMED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTO$ ONLY AUTOSONLY I I 4544503 6/1/2020 6/1/2021 COMBINED $INGLE LIMIT(Ea acadentL -'- I $1,000,000 BODILY INJURY (Par person) $ BODILY INJURY (Per aoddent) $ PROPERTY DAMAGE Per accldenij $ $ UMBRELLA LIAB EXCESS LIA6 OCCUR CLAIMS -MADE I EACHOCCURRENCE $ EGATE s DED I I RETEMION$ $ B WORKERSCOMPENSATION AND EMPLOYERVLIABILITY YIN ANYPROPRIETOP/PARTNER/EXECUTIVE OFFICERMIEMBEREXCLUDED9 - (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 25893860 6/1/2020 6/1/2021 X I SPER TATUTE OERH E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE. $1,000.000 E.L. DISEASE -POLICY LIMIT $ 1,000.000 DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (ACORD 101, Additional RE: City of Fort Collins Transfort Bus stop Upgrades City of Fort Collins is additional insured for general liability and Remarks Schedule, may be attached If more space is required) automobile if required by written contract executed prior to loss. CANCELLA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Purchase Dept. PO Box 580 AUTHO3 OREPRESENTATI Fort Collins CO 80522-0580 � I mow✓ ©1988-2015 ACORD CORPORATION, All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD