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HomeMy WebLinkAbout539869 LIGHTFIELD ENTERPRISES INC - INSURANCE CERTIFICATE (15)/ 1 ® DATE (MM/DD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE f`i 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 _ NAME: The Harry A. Koch Co. PHONE 402-861-7000 AC.NoI: P.O. Box 45279 E-M IEx,,; L Omaha NE 68145-0279 ADDRESS: INSURER AFFORDING COVERAGE NAIC # INSURER A: National Union Fire Ins Co. of Pitt 19445 INSURED LIG46636 INSURERS: New Hampshire Ins Company 23841 Lightfield Enterprises 2600 Midpoint Drive INSURERC: Fort Collins CO 80525 INSURER D : I I INSURER F: I 1 rr1VFRAr:FR CFRTIFICATF NIIMRFR•9R0159R1R RFVIRION NIIMRFR- 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 LTR OF INSURANCE ADDITYPE INSD WVQSUBRI POUCY NUMBER MM/DDPOLICY /YYYY MM/DDIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE X OCCUR 3506965 4/21/2018 6/12018 EACH OCCURRENCE $1,000,000 DAMAGE TRENTED-- PREMISES Ea oocurrenoel $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑PRO JECT � LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS -COMP/OPAGG $2,000,000 $ A AUTOMOBILE LIABILITY IANYAUTO 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 Per accident $ UMBRELLA LIAB EXCESS LIAB HOCCUR CLAIMS -MADE EACHOCCURRENCE $ AGGREGATE $ DED RETENTION $ $ B.WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 025893877 4212018 6/12018 X STATUTE ER 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 Remarks Schedule, may be attached if more space is required) RE: Snow & Ice Removal Contract No. 7564. Certificate holder is additional insured for General Liability and Automobile 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 PO Box 580 AUTHO DREPRESENTATIV 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