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HomeMy WebLinkAbout539869 LIGHTFIELD ENTERPRISES INC - INSURANCE CERTIFICATE (17)C� ® DATE(MMIDD/YYYY) AC")?" CERTIFICATE OF LIABILITY INSURANCE 4i19/2018 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. PHONE - — FAx P.O. Box 45279 EXtk 402-861-7000 (A/C, No): Omaha NE 68145-0279 ADDRIESS: INSURED Lightfield Enterprises 2600 Midpoint Drive Fort Collins CO 80525 LIG46636 c: National Union Fire Ins Co. of Pitt New Hamoshire Ins Companv rOVFRAAFS CFRTIFICATF Nt1MBFR-A43A2A0An REVISION NUMBER: 19445 23841 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 SUER OUCPOLICY NUMBER MM/DDY/YYYY MMIDD/YYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILITY 3506965 421I2018 6/1/2018 EACHOCCURRENCE $1,000,000 ❑X OCCUR A AGE ToCLAIMS-MADE PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ 5,000 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO JECT LOC PRODUCTS-COMPIOP AGG $ 2,000,000 _ $ OTHER: A AUTOMOBILE LIABILITY 4544903 4212018 6/1/2018 COMBINED SINGLELIMIT Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS 1X BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident) $ _ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE EXCESS LAB $ DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANYPROPRIETOR/PARTNER/EXECUTIVE 025893877 4212018 6/1/2018 X STATUTE ERH E.L. EACH ACCIDENT $1,000,000 _ OFFICER/M EMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 1,000,000_ E.L. DISEASE - POLICY LIMIT IDESCdescribe unR PTION OFder OPERATIONS below $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: BID No. 8344 - Concrete Maintenance Project Phase III. Certificate holder is additional insured for General Liability and Automobile Liability if required by written contract executed prior to loss. CERTIFICATE HOLDER GANGtLLA I ION City of Fort Collins Purchasing Division 215 N. Mason Street, 2nd Floor Fort Collins CO 80524 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 ,SE�IV ✓y �. ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD