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HomeMy WebLinkAboutCITY OF FORT COLLINS - INSURANCE CERTIFICATEDATE A0Q CERTIFICATE OF LIABILITY INSURANCE 04/(24/2007) PRODUCER (303) 773-9999 FAX (303) 773-9776 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher Risk Management Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6399 S. Fiddlers Green Circle #200 Attn: Tammy Hennig Greenwood Village, CO 80111 INSURED Citv of Fort Collins P.O. Box 580 Fort Collins, CO 80522 rnvconr_cc INSURERS AFFORDING COVERAGE INSURERA: Princeton E&S INSURER B: INSURER C: INSURER D: INSURER E: NAIC # 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD' UqPDATE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE IMMIDDIYYI POLICY EXPIRATION DATE (MMIDDfYYI LIMITS GENERAL LIABILITY N1A3RL000004800 04/15/2007 04/15/2008 EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY COV A.- GEN LIAB DAMAGE TO RENTED PREMISES (Fa ocrjirancp.) $ CLAIMS MADE [fl OCCUR AUTO LIAB . , LEL LIAB IVIED EXP (Anyone person) $ A X X SIR $500,000 per COV B PUBLIC OFFICIALS PERSONAL& ACV INJURY $ occurrence GENERAL AGGREGATE $ 500,00 LIABILITY GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY M PROJECT M LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY N1A3F0000000600 04/15/2007 04/15/2008 EACH OCCURRENCE $ 2,500,000 X OCCUR CLAIMS MADE AGGREGATE $ A X $ S,500,00 $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OTH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ If yes describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS e: Fort Collins Capital Leasing Corporation is named Additional Insured as respects General Liability coverage regarding the Lease Agreement dated July 27, 2004 for Deicing Facility which terminates on June 1, 2023 and for Police Building which terminates on June 1, 2026. PCoTICIr`ATC UC%l nro PAUr C% I AT%n%% SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Fort Collins Capital Leasing Corporation 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 21SN . Mason Street BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY PO Box S80 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80S22 AUTHORIZED REPRESENTATIVE Karen Graham H^- ACORD 25 (2001/08) ©ACORD CORPORATION 1988 ACORD - 1z Y DATE (MMIDDIYY) a _It ��� 04J24/2007 �r _ PRODUCER (303) 773-9999 FAX (303) 773-9776 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur 3. Gallagher & Co. - Denver ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 6399 S. Fiddlers Green Circle, Suite 200 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Greenwood Village, CO 80111 COMPANIES AFFORDING COVERAGE COMPANY Lexington Insurance Company Attn Ext A INSURED City of Fort Collins COMPANY B P.O. Box 580 Ft Collins, CO 80522 COMPANY C COMPANY D 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. CO TYPE OF INSURANCE POLICY NUMBER LTR POLICY EFFECTIVE '' POLICY EXPIRATION j COVERED PROPERTY LIMITS DATE (MMIDDIYY) DATE (MMI)DIYY) :. X PROPERTY TBD 04/15/2006 04/15/2007 BUILDING $ CAUSES OF LOSS PERSONAL PROPERTY $ BASIC :. - 1 BUSINESS INCOME $ !BROAD EXTRA EXPENSE : $ A X ;SPECIAL I BLANKET BUILDING 5 i EARTHQUAKE BLANKET PIERS PROP $ FLOOD { X i BLANKET BLDG & PP $ 100000000 X Vehicles/Mobile XI Policy Ded s 50,000 ;Equipment ;X!Vehicle Ded $ 100,000. _.; INLAND MARINE _; i _ 1 $ TYPE OF POLICY $ CAUSES OF LOSS f $ NAMED PERILS $ OTHER ' $ CRIME I $ TYPE OF POLICY j 5 BOILER 6 MACHINERY �, _.._ $ OTHER I LOCATION OF PREMISESIDESCRIPTION OF PROPERTY SPECIAL CONDITION THER COVERAGES e: Fort Col ins Capital Leasing Corporation is named Additional Insured as respects General iability coverage regarding the Lease Agreement dated July 27, 2004 for Deicing Facility which erminates on June 1, 2023 and for Police Building which terminates on June 1, 2026. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Fort Collins Capital Leasing Corporation 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 215N . Mason Street BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY PO BOX 580 OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE y Fort Collins, CO 80522 Karen Graham/TMH�-^-� IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ra Wmu ca icuv I/vaf Additional Coverages and Factors 04/24/2007 Line of Business Coverages for General Liability Coverage Limits Ded/Ded Type Rate Premium Factor General Aggregate 500,000 Each Occurrence 500,000 500,000