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Home My WebLink About132292 MUSCO SPORTS LIGHTING LLC - INSURANCE CERTIFICATE (2)® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDNYYY) 06/29/2018 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 AOn Risk Services Central, Inc. Omaha NE office CONTACT NAME: PHONE (402) 697-1400 FAx (402) 697-0017 (A/C. No. Eat): A/C. No.: E-MAIL ADDRESS: 11213 Davenport suite 201 INSURER(S) AFFORDING COVERAGE NAIC # Omaha NE 68154 USA INSURED MUsco Sports LiOhtincl, LLC INSURER A: Sentry Insurance A Mutual Company 24988 INSURERB: Sentry Casualty Company 28460 c/o Musco corporation 100 1St Ave W INSURER C: INSURER D: Oskaloosa IA 52577 USA INSURER E: INSURER F: rnvronr�cc CERTIFICATE NUMBER' 57nn72117906 REVISION NUMBER: vTHIS 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDNYYY MMIDDNYYY LIMITS X COMMERCIALGENERALLIABILITV EACH OCCURRENCE $1,000,000 CLAIMS -MADE a OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $300,000 MED EXP (Any one person) $10 , 000 PERSONAL &ADV INJURY $1,0001000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 POLICY PRO F-1 LOC JECT OTHER: A AUTOMOBILE LIABILITY Y 901687703 07/01/2018 07/01/2019 COMBINED SINGLE LIMIT Ea accident $1,000,000 BODILY INJURY ( Per person) X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS PROPERTY DAMAGE X HIREX NON -OWNED ONLY AUTOS ONLY Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LAB CLAIMS -MADE DED RETENTION B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANV PROPRIETOR / PARTNER / EXECUTIVE N 901687701 07/01/2018 07/01/2019 X STATUTE ORH E.L. EACH ACCIDENT $1,000,000 E. L. DISEASE -EA EMPLOYEE $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It s, describe under DESCRIPTION OF OPERATIONS below N / A _ E.L. DISFASF-POLICY LIMIT $1 , 000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Blanket Agreement, Expires 5/18/19. Additional Insured including Completed operations in favor of the City of Fort Collins applies on the General and Auto Liability policies. waiver of Subrogation in favor of the certificate holder applies on all policies. General Liability coverage is primary and non-contributory. Umbrella coverage is follow form. 30 day notice of cancellation will be provided. CERTIFICATE HOLDER CANCELLATION s 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 AUTHORIZED REPRESENTATIVE PO BOX 580 Fort Collins CO 80522 USA ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD `m