HomeMy WebLinkAboutCFG CONCESSIONS - INSURANCE CERTIFICATE (3)OCT 14 2004 17:26 FR
TO 2216707 P.01i01
ACDRD CERTIFICATE OF LIABILITY INSURANCI OPID DATE(MMIDDIYY)
GCO-1 10/14/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Lno - Ft Collins ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, 5th Floor HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80522-2226
Phone:970-482-7747 Fax:970-484-4165 INSURERS AFFORDING COVERAGE
CFG Concessions "-
Wanton Router INSURER C
F01 ortSC3y11isal ns COe80525 INSURER O:
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTYWFHSTANDING
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W17H RESPECT TO WHICH THIS CERTIFICATE MAY RE 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,
M117—
LTR
TYPE OF INSURANCE
POLICY NUMBER
DATE MMRTWYY
OATS MMID
J LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
S
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE f7 OCCUR
FIRE DAMAGE (Arty one Fvo)
S
i
MED EXP (Any c po o )
PERSONAL SADV INJURY
S --
_,..._,. .-._
_.,.-_.-_
GENERAL AGGREGATE
S
GEN L AGGREGATE LIMIT APPLIES PER
POLICY .._^ JEC LOC
PRODUCTS • COMPIOP AGG
S
_.'.-._.
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ee eeeleen)
S
ALL OWNED AUTO$
SCHEDULED AUTOS
BODILY INJURY
(Per person)
$
HIRED AUTOSNON-OWNED
AUTOS
BODILY INJURY
4Per eccldenD
S
PROPERTY DAMAGE
(Per wzwero)
.
_—.
i
GARAGE LIABILITY
ANY AUTO
AUTO ONLY -EA ACCIDENT
S
OTHER THAN EA ACC
AUTO ONLY: AGO
$-,-
$
EXCESS LIABILITY
_ OCCUR (� CLAIMS MADE
EACH OCCURRENCE_
S
AGGREGATE
S
b
DEDUCTIBLE
s
RETENTION b
i
A i
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THD
10/15/04
10/15/05
X TORY VAT ER
.,,.
EL.EACHACCIDENT
i100000
9 L. DISEASE - EA EMPLOYEES
100000
E.L.DISEASE - POLICY LIMIT 5 500000 �
TH
OER
DESCPBPTION OF OPERATIONS/LOGATONSNEHICLESIEXCLUSIONS ADM BY ENOORSEMENTISPECWL PROVISIONS
FAX 221-6707
CFRTIFIAATC IJAI MITO
City of Fort Collins
Purchasing Division
Attn: David Carrey
PO Box 580
Fort Collins CO 80522-0580
CITYDI-V SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO RLAIL .10_ 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
25-S (7197)
** TRTOI POf;P R1 **
Ate. CERTIFICATE OF LIABILITY INSURANCE,,, P o
TE (MM/DWYY�
DA04/26/04
PRODUCER
Brown
12�
P Q
Fo
Phone:970-482-7747
& Brown Inc - Ft Collins
S Howes, 5th. Floor
Box 2226
t Collins CO 80522-2226
Fax:970-484-4165
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
TNSL RED
CFG Concessions
Weston Router
401 Skysail Lane
Fort Collins CO 80525
INSURER A: UNITED FIRE & CASUALTY
INSURER B:
INSURER C:
INSURER D:
INSURER E.
COVE
-RAGES
A
1E
M
P
POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
Y REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR
Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
LICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
LTR
A'
TYPE OF INSURANCE
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ❑X OCCUR
POLICY NUMBER DATE
60310812
lY
MMIDDY
05/14/04
DIYY
DATE MMPDN
05/14/05
LIMITS
EACH OCCURRENCE
$ 1,000,000
FIRE DAMAGE (Any one fire)
$ 100,000
MED EXP (Any one person)
$ 5,000
PERSONAL &ADV INJURY
$1,000,000
GENERAL AGGREGATE
s2,000,000
PRODUCTS - COMP/OP AGG
$2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO- LOC
JECT
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS —
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Par accident)
$
i
GARAGELIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESS LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
4EACHACCIDENT
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
_
ER
E
$EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
OTHER
DES
RIPTION OF OPERATIONSILOCATIONSIVEHICLES!EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
CE
TIFICATE HOLDER N I ADDITIONAL INSURED; INSURER LETTER: _ CANCELLATION
CITYFT7
City of Fort Collins
Purchasing Division
P. 0. Box 580
Fort Collins CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR Li ITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATI , J
a wnnen rnoonDe TlnAl 90RA
ACPRD 25-S (7/97)