HomeMy WebLinkAboutDISH NETWORK CORPORATION - INSURANCE CERTIFICATE (4)AE;U RD,M CERTIFICATE OF LIABILITY INSURANCE
8/l/2019
FDATE(MM/DD/YYYY)
1 7/27/2018
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 Lockton Companies
CONTACT
8110 E. Union Avenue
Suite 700
Denver CO 80237
fPA,CNdExt): AIC No):
E-MAIL
ADDRESS:
INSURER AFFORDING COVERAGE
NAIC p
(303) 414-6000
INSURER A: ACE American Insurance Company
22667
INSURED DISH Network Corporation
1033161 DISH Network LLC
9601 S. Meridian Blvd.
INSURER B :
INSURER c
INSURER D :
Englewood, CO 80112
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: 12709221 RFVISICIN NHMRFR- XXXXXXX
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
TYPE OF INSURANCE
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MM/ D/YYYY
POLICY EXP
(MM/DD/YYYYI
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
N
N
XSLG71212208
8/1/2018
8/1/2019
EACH OCCURRENCE
1 OOO OOO
CLAIMS -MADE � OCCUR
PREAGE
PREMISES (ETO a occurrence)
300,000
X
MED EXP (Any oneperson)
XXXXXXX
Standard
Contractual Liab.
PERSONAL & ADV INJURY
$ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER:
POLICY JECOT- LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 21000,000
$
OTHER
AUTOMOBILE
LIABILITY
ANY AUTO
NOT APPLICABLE
EOMaBIINEDtSINGLE LIMIT
$ XXXXXXX
BODILY INJURY (Per person)
$ XXXXXXX
OWNED SCHEDULED
AUTOS ONLY AUTOS
BODILY INJURY (Per accident
$ XXXXXXX
ED
AUTOS ONLY AUUTO ONLY
RTY
Peer accidenDAMAGE
$ XXXXXXX
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$ XXXXXXX
EXCESS LIAB
CLAIMS -MADE
NOT APPLICABLE
AGGREGATE
$ XXXXXXX
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PRO PRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N / A
NOT APPLICABLE
PER OTH-
STATUTE HER
E.L. EACH ACCIDENT
$ XXXXXXX
E.L. DISEASE - EA EMPLOYEE
XXXXXXX
E.L. DISEASE- POLICY LIMIT
XXXXXXX
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: DISH Installation at certificate holder location. Certificate Holder is named as Additional Insured where required by written contract with respect
to General Liability.
CERTIFICATE HOLDER
12709221
City of Fort Collins
PO Box 580
Fort Collins GO M22
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 REPRESENTATIVE
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1
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