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Home My WebLink About539869 LIGHTFIELD ENTERPRISES INC - INSURANCE CERTIFICATE (18)A DATE (MM/DD YYYY) 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 NAME: The Harry A. Koch Co. PHONE — - - FAX P.O. Box 45279 • 402-861-7000 A/c No): _ Omaha NE 68145-0279 E-MAIL SS: INSURED Lightfield Enterprises 2600 Midpoint Drive Fort Collins CO 80525 LIG46636 F INSURER F r0 VFRAr;Ff2 CFRTIFICATF NtIMBFR- 194577R975 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 ADDL SUER POLICY EFF POLICY EXP LTR POLICYNUMBER MMDD/YYYY MMIDD YYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 3506965 421/2018 6/12018 EACHOCCURRENCE $1,000,000 CLAIMS -MADE FXI OCCUR $ 50,000 DAMAGE TO RENTE PREMISES Ea occurrence MED EXP (Any one person) $ 5,000 PERSONAL BADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY ❑PRO � LOC JECT $ OTHER: A AUTOMOBILE LIABILITY 41018 6/11 206 COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON�OWNED AUTOS ONLY AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACHOCCURRENCE $ AGGREGATE $ EXCESS LIAR DED I I RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y❑ 0256931177 4212018 6/12018 X STAT TE EERH E.L. EACH ACCDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000.000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) NIA E.L. DISEASE - POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required( Project: 8687 Concrete Maintenance Project Phase II. Certificate holder is additional insured for General Liability and Automobile Liability if required by written contract executed prior to loss. The General Liability policies have been endorsed to provide 30 days notice of cancellation, except for cancellation for nonpayment of premium, in which case 10 days notice of cancellation will be provided n 1111—lit u^I nco I-AKIr FI I ATI1711J 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 2nd Floor, 215 N. Mason St. Fort Collins CO 80522 AUTHORiZEDREPRESENTATIV U 1988-ZU15 AGUKU GUKI'UKA I IUN. An rlgnLS reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD