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Home My WebLink AboutCITY OF FORT COLLINS - INSURANCE CERTIFICATE (8)ACORD,„ CERTIFICATE PROPER'Y INSl1RANCE OF oiizzi?oos 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, 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 COVERAGES': 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY T1 Ir 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 COVERED PROPERTY LIMITS DATE(MMIDDNY) DATE(MMIDONY) X PROPERTY 8755925 04/15/2007 04/15/2008 BUILDING 5 CAUSES OF LOSS PERSONAL PROPERTY $ BASIC BUSINESS INCOME $ BROAD EXTRA EXPENSE $ A X SPECIAL BLANKET BUILDING $ EARTHQUAKE BLANKET PERS PROP S FLOOD X BLANKET BLDG & PP S 100000000 X Vehicles/Mobile X Policy Ded $ 50,000 _ Equipment X Vehicle Ded $ 100,000 INLAND MARINE —' $ TYPE OF POLICY $ S CAUSES OF LOSS $ NAMED PERILS $ OTHER $ CRIME S TYPE OF POLICY $ S BOILER & MACHINERY _ $ $ OTHER LOCATION OF PREMISESIDESCRIPTION OF PROPERTY SPECIAL CONDITIONS/OTHER COVERAGES ertificate Holder is named as a Loss Payee as their interests may appear for mobile equipment. E: PO# 8850391, Komatsu PC30OHD-7 with ThumbKit A86114, Komatsu PC30OLC-7 s/n J20350 and PK Processor M-38 s/n 85938 CERTIFICATE HOLDER:CANCELLATION.: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Power Motive Corporation 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn: Kevin BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5000 Vasquez Blvd OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, AUTHORIZED REPRESENTATIVE "1`-� Denver, CO 80216 Karen Graham/TMH 1 -ACORD 24 (1196) ' r ©ACtlRD.CGRPORATION 199„ AGOW.,, CERTIFICATE OF LIABILITY INSURANCE of/22/20 Y' PRODUCER (303)773-9999 FAX (303)773-9776 Arthur J. Gallagher Risk Management Services, Inc. 6399 S. Fiddlers Green Circle Suite 200 Greenwood Village, CO 80111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 INSURERA: Princeton E&S INSURER B: INSURER0: - - - INSURER D: INSURER E: COVERAGES 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 ADD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY N1A3111-000004800 04/15/2007 04/15/2008 EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY _ DAMAGE TO RENTED $ CLAIMS MADE111 OCCUR COV A - GENERAL LIAB MED EXP(Any one person) $ A X X SIR $500,000 Per AUTO LIAB., LEL LIAB. PERSONAL &ADV INJURY S COV B-PUBLIC OFFICIALS Occurrence GENERAL AGGREGATE $ SOO,000 LIABILITY GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ X POLICY JECT LOC AUTOMOBILE LIABILITY ANY AUTO NIA3111-000004800 04/15/2007 04/15/2008 COMBINED SINGLE LIMIT (Ea accldenU $ INCLUDE X BODILY INJURY (Per person) $ IN A x ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ GENERA HIRED AUTOS NON,OWNED AUTOS PROPERTY DAMAGE (Per oscldent) S LIABILI GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S OTHERTHAN EAACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY N1A3F0000000600 04/15/2007 04/15/2008 EACH OCCURRENCE $ 2,500,000 X OCCUR D CLAIMS MADE AGGREGATE $ A x $ 51500,000 S DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- OThI- TORY 1. MITc EMPLOYERS' LIABILITY ANY PROPRIETOR/ RIEXECUTIVE .,._-. E.L. EACH ACCIDENT $ _ L'.L. DISEASE-er EAEMPLOYE $ OFY6ICEsvibound EXCLUDED? EXCLUDED? SPECIAL PROVISIONS belov, EL. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT l SPECIAL PROVISIONS Certificate Holder is named as an Additional Insured as their interests may appear for mobile equipment E: PO# 8850391, Komatsu PC30OHD-7 with Thumb Kit A86114, Komatsu PC30OLC-7 s/n J203SO and PK Processor M-38 s/n 85938 Power Motive Corporation Attn: Kevin 5000 Vasquez Blvd Denver, CO 80216 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY AUTHORIZED REPRESENTATIVE V p Karen Graham/TMH 1`t'^° "J, ACORD 25 (2001108) ©ACORD CORPORATION 1988 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. ACORD 25 (2001/08)