HomeMy WebLinkAboutUNITED WAY OF LARIMER COUNTY - INSURANCE CERTIFICATEACORD,�., CERTIFICATE OF LIABILITY INSURANCE 0627107°'"""
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 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC #
United Way of Larimer County
424 Pine Street #102
Fort Collins, CO 80524
COVERAGES
INSURER A: Philadelphia Insurance
INSURER B. Pinnacol Assurance
INSURER C.
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
NSR
TYPE OF INSURANCE
POLICY NUMBER
PDATE(MM/DD/YYCY EFFECTIVE
POLICY DATE MPDDNYN
LIMITS
A
GENERAL LIABILITY
PHPK172091
07/0110T
07/01108
EACH OCCURRENCE
S1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTEDPREMISES Ea occurrence)
$100000
CLAIMS MADE a OCCUR
MED EXP (Any one person)
$j 000
PERSONAL B ACV INJURY
S1,000,000
GENERAL AGGREGATE
$2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
s2,000,000
POLICY PRO-LOC
ECT
A
AUTOMOBILE
LIABILITY
ANY AUTO
PHPK172091
07/01/07
07/01/08
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULEDAUTOS
X
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESS/UMBRELLA LIABILITY
PHUB063515
07/01/07
07/01/08
EACH OCCURRENCE
S1 000000
OCCUR CLAIMS MADE
AGGREGATE
$1 00O 000
$
DEDUCTIBLE
$
X RETENTION $ 10000
B
WORKERS COMPENSATION AND
1139112
07/01/07
07/01/08
X TWOSTATU- OTH-
EMPLOYERS' LIABILITY
ANY PROPRIETORiPARTNERiEXEOUTIVE
E.L. EACH ACCIDENT
$500,000
E.L. DISEASE - EA EMPLOYEE
s500,000
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
s500,000
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
Certificate Holder is listed as Additional Insured as their interests may
appear regarding: Emergency Shelter for the homeless during winter months.
City of Fort Collins: Attn: Jim
O'Neil, City Purchasing Dept.
P O Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL In DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AI.UKU1 LD ILUU1111,16/ 1 of 2 #M385528 TJR 0 ACORD CORPORATION 1988