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HomeMy WebLinkAbout539869 LIGHTFIELD ENTERPRISES INC - INSURANCE CERTIFICATE (14)A ® DATE (MM/DD VYYY) CERTIFICATE OF LIABILITY INSURANCE 4/19/2018 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 CONTACT The Harry A. Koch Co. NAME: - FAX P.O. Box 45279 lo. E,d): 402-861-7000 (A/C. NorAIL _ Omaha NE 68145-0279 ADDRESS: INSURED Lightfield Enterprises 2600 Midpoint Drive Fort Collins CO 80525 LIG46636 INSURER(S) AFFORDING COVERAGE NAIC 0 RA: National Union Fire Ins Co. of Pitt _ 19445 INSURER F : r1nX1r0Ar_FQ r`FRTIFICATF NI IMRPR• AA AQ3AddR RFM-RION NIIMRFP- 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 EXP LTRR TYPE OF INSURANCE ADDL SUER POLICY NUMBER (MMIDDMlYY) (MM/DDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I OCCUR 3506965 4/21/2018 6/12018 EACH OCCURRENCE $ 1,000,000 $50,000 $ 5,000 PREMISES Ea occurrence MED EXP (Any oneperson) PERSONAL &ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT OTHER: GENERAL AGGREGATE $2.000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 4544903 4212018 6112018 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccclert $ $ UMBRELLA LIAR EXCESS LIAB HCLAIMS-MADE OCCUR EACHOCCURRENCE $ AGGREGATE $ DIED I I RETENTION $ $ 8 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE —] OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A 025693877 4212018 6/1/2018 X STATUTE ERH E.L. EACH ACCIDENT $1,D00,000 E.L. DISEASE -EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 I I DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Miscellaneous Concrete Contract (Bid# 7658). Certificate holder is additional insured for General Liability and Auotmobile Liability if required by written contract executed prior to loss. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Purchasing Division PO Box 580 AUTHOR17ED REPRESENTATIV Fort Collins CO 80522 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD