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PREMIER FIRE PROTECTION - INSURANCE CERTIFICATE
ACORD, CERTIFICATE OF LIABILITY INSURANCE 11/29107°'"""' PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc 4821 Wheaton Drive ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 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 # INSURED INSURER Lexington Insurance Company Premier Fire Protection, Inc INSURER B National Union Fire Insurance 630 West 1st Street Loveland, CO 80537 INSURER C PlnnaCol Assurance INSURER D The Hartford Insurance USURER E COVERAGES THE POLICIES OF INSURANCE LISTED 13ELOW 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 POLICY EFFEC FIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR X PD Ded 2,500 41LX03222163 12/04/07 12/04/08 EACH OCCURRENCE $1000000 AMAX PREMIISE O RENCTED $100OOD MED EXP (Any one person) $ PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2 000 000 GEN L AGGREGATE LIMIT APPLIES PER POLICY X JECT IOC PRODUCTS COMP/OPAGG $2000000 D AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS 34UECTZ4728 12/04/07 12/04/08 COMBINED SINGLE LIMIT (Ea accident) $1, 000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per acadont) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTOONLY EAACCIDENT $ OTHER THAN EA ACC AUTO ONLY AGO $ $ B EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $ o BE1048111 12/04/07 12/04/08 EACH OCCURRENCE $5 000 000 AGGREGATE $5 000 000 $ $ C WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED' If yes describe under SPECIAL PROVISIONS below 4064026 12/01/07 12/01/08 X WCSTATU OTH T EL EACH ACCIDENT $1,000,000 EL DISEASE EA EMPLOYEE $1,000,000 EL DISEASE POLICY LIMIT $1,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins PO Box 580 Fort Collins, CO 80522-0580 LD AN Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10_ DAYS WRITTEN E TO 1 HE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IE NO OBLIGATION OR LIABILIT V OF ANY KIND UPON THE INSURER ITS AGENTS OR AUTHORIZED REPRESENTATIVE ACORD 25 (2001/08) 1 of 2 #M399929 MJP © ACORD CORPORATION 198E 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 poli(.y, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in heu of such endorsement(s) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing inswer(s), authorized representative or producer, and the cerfificale holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon ACORD 25-S (2001/08) 2 of 2 #M399929