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HomeMy WebLinkAbout127569 FRONT RANGE INTERNET INC - INSURANCE CERTIFICATE (6)ACC " CERTIFICATE OF LIABILITY INSURANCE DATE 11/9/2015Yv> 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT Rosemary Kislin CIC NAME: y g• PHONE AIC(970)266-7158 A/C No: (970)506-6845 AoDRIL .RKislingQfloodpeterson.com INSURERS AFFORDING COVERAGE NAIC k INSURERA:Chubb Group of Insurance Co INSURED Front Range Internet, Inc. 3350 Eastbrook Drive Fort Collins CO 80525 INSURERB:Pinnacol Assurance 41190 INSURER C : INSURERD: INSURER E : INSURERF: COVERAGES CERTIFICATE NUMBER:CL1511306947 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 ADDL SUBfl POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM% D/YYYY MM /DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE To PREMISES EaoccurD"e $ 1,000,000 A CLAIMS -MADE a OCCUR X 35784775WCE 1/1/2015 1/1/2016 MED EXP (Any one person) S 10,000 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,000 $ X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 BODILY INJURY (Per person) $ A X ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED 1474970114 1/1/2015 1/l/2016 AUTOS AUTOS PROPERTY DAMAGE $ X X NON -OWNED HIRED AUTOS AUTOS Per accident Underinsured motorist $ 11000,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ 93631904 1/1/2015 1/1/2016 B WORKERS COMPENSATION WC STATU- I OTH- AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A 4054469 /1/2015 /1/2016 E.L. DISEASE - EA EMPLOYE4 $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below I I E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 A Errors & Omissions 1/1/2015 1/1/2016 $2,000,000 L784775WCE Ded $10,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. ltl a al l l a Nlt\ I =0: PJ 1111 a: 19 L913R4L11Lei City of Fort Collins Director of Purchasing & Risk Management 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 (2010/05) INS025 (201005).01 R Kisling, CIC/RKISLI'^"`�' © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Additional Named Insureds Other Named Insureds Eastbrook Ventures, LLC Front Range Internet, Inc. Additional Named Insured Additional Named Insured OFAPPINF (02/2007) COPYRIGHT 2007, AMS SERVICES INC