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HomeMy WebLinkAbout539869 LIGHTFIELD ENTERPRISES DBA VOGEL CONCRETE - INSURANCE CERTIFICATE (3)Fax: (970)221.6776 ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MMIOD YVW) 04/23/2016 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 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 CONTACT Tad Borrett Security Insurance Group, LLC PHONN.E 970-378-4818 ac No). 970.378-4820 8219 W 20th St, Ste A E-MAIL ADDRESS: sig@securityinsurancegroup.net Greeley, CO 80634 INSURER 5 AFFORDING COVERAGE NAIL Y INSURERA: INSURED Lightfield Enterprises, Inc INSURER 8: Auto Owners Insurance DBA Vogel Concrete, Inc INSURER C: All Risks Ltd 2601 Riverbend Ct INSURER D: Pmnnacol Assurance Fort Collins, CO 80626 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER, 0000A297.84756 RFVISInN NUMBER- 2 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 ADD INSRPOUCYNUMBER S I POLICY EFF IMMIDDIYYM POLICY EXP (MMIDDfWMLIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITYoccurrence)$ CLAIMS -MADE ® OCCUR Y Y 3266216 04/21/2015 04/21/2016 EACH OCCURRENCE $ 1 000 000 DAMAGE TO RENTED 100,000 MED EXP (Any onePerson) $ 6.000 PERSONAL 3 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS-COMP/OPAGG $ 2000000 $ B AUTOMOBILEUABILITY X. ANY AUTO ALLCWNED SCHEDULED __, AUTOS AUTOS _ X HIREDAUTOS NON -OWNED AUTOS Y 60-333466-00 04121/2015 04/21/2016 COMBINED SINGLE LIMIT BODILY INJURY (Per person) $ BODILY INJURY (Peraaiderlt) $ PROPERTY DAMAGE $ `" X UMBRELLA LAB EXCESS UAB OCCUR CLAIMS -MADE Y Y CAEX0000063666 041'21/2015 04/21/2016 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DIED RETENTION $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDEDO (Mandatory in NH) It yes, describe udder DESCRIPTION OF OPERATIONS oel NIA Y 4173268 05/01/2015 05/01/2016 X VJCSTATU- OTH- FR E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE- EA EMPLOYEE $ 100,000 E.L. DISEASE -POLICY LIMIT I $ 600000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Anach ACORD 101, Additional Remarks Schedule, 9 more apace is required) Project: 7361 Concrete Mainenance Project Phase 1-2015 Renewal. If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability and auto liability. City of Fort Collins Purchasing Division 2nd Floor 216 N Mason Street Fort Collins, CO 80624 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD Printed by TCB on April 23, 2015 at 02:38PM