HomeMy WebLinkAboutPhase II Company - Insurance Certificate ACO® DATE(MMIDD/YYYY)
AC� CERTIFICATE OF LIABILITY INSURANCE F03/14/2025
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 Dana Stewart,CIC,CISR
NAME:
Flood and Peterson PHONE (g70)266-7149 FAX (970)506-6845
AIC No Ext: AIC,No):
PO Box 578 E-MAIL DStewart@floodpeterson.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
Greeley CO 80632 INSURERA: American Zurich Insurance Company 40142
INSURED INSURER 8: American Guarantee and Liability Insurance Company 26247
Phase II Company dba Phase 2 Company INSURER c; Pinnacol Assurance 41190
216 Hemlock St INSURER D:
INSURER E:
Fort Collins CO 80524 INSURER F:
COVERAGES CERTIFICATE NUMBER: GL/AU/WC/XSx4/2026 REVISION NUMBER:
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 AUDL SUBR POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 2,000,000
CLAIMS-MADE ❑X OCCUR PREM ES(RENTED 100,000
PREMISES RENT n-ence $
X PD Deductible$5,000 per occ MED EXP(Any one person) S 10,000
A GLO 6710788-04 04/01/2025 04/01/2026 PERSONAL&ADV INJURY S 2,000,000
GEN'L AGGREGATE LIMITAPPLIES PER; GENERAL AGGREGATE S 4,000,000
POLICY �jE 7 F> PRODUCTS-COMP/OP AGG S 4,000,000
OTHER: S
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S 1,000,000
Ea accident
IX
ANY AUTO BODILY INJURY(Per person) S
AOWNED SCHEDULED BAP 6710789-04 04/01/2025 04/01/2026 BODILY INJURY(Per accident) S
AUTOS ONLY AUTOS
HIRED �/ NON-OWNED PROPERTY DAMAGE S
AUTOS ONLY X AUTOS ONLY Per accident
S
X UMBRELLA LIAB X OCCUR EACH OCCURRENCE S 5,000,000
A EXCESS LIAR CLAIMS-MADE AUC 6508348-04 04/01/2025 04/01/2026 AGGREGATE S 5,000,000
DED I X1 RETENTION$ O S
WORKERS COMPENSATION X
AND EMPLOYERS'LIABILITY STATUTE EORH StopGap WY ind
B ANY PROPRIETOR/PARTNER/EXECUTIVE YIN
500,000
OFFICER/MEMBER EXCLUDED? NIA 2203950 04I01/2025 04/01/2026 E.L.EACH ACCIDENT $
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
281 North College Avenue
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80524
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