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ADCON - INSURANCE CERTIFICATE
ACORDTM CERTIFICATE OF LIABILITY INSURANCE ODATE 6/29/07Omrv) PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drive P O Box 270370 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED AdcINSURER 3725 Inc. Fort Collins, CO 80524 Canal Drive Fort A: The Hartford Insurance INSURERB: Fireman's Fund Insurance, Co. INSURERC: Pinnacol Assurance INSURER D: INSURER E: 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. LTR I-NSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DO/YY LIMITS A GENERAL LIABILITY 34UUNTX2812 07/01/07 07/01/08 EACH OCCURRENCE $1 QQQ QQQ X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX] OCCUR DAMAGE TO RENTED PREMISES (Fa occumence)$300 000 MED EXP (Any one person) $10 000 PERSONAL B ADV INJURY $1 QQQQQO GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000000 POLICY X PRO LOC JECT A AUTOMOBILE LIABILITY ANY AUTO 34UUNTX2812 07/01/07 07/01/08 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) $ HIREDAUTOS NON -OWNED AUTOS X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG B EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE SSE000773330 07/01/07 07/01/08 EACH OCCURRENCE $S QQQ QQQ AGGREGATE $5 QQQ QQQ RDEDUCTIBLE X RETENTION $ Q $ Ci WORKERSCOMPENSATION AND EMPLOYERS' LIABILITY 4020883 07/01/07 07/01/08 X WCSTATU- I OTH- E.L. EACH ACCIDENT $1,000 000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1 000,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS All Operations - All Locations City of Fort Collins 300 Laporte Avenue Fort Collins, CO 80521 LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL _0 DAYS WRITTEN :E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR I--- - --r I V1 � wln000 law NIK © ACORD CORPORATION 1988