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374454 ARTHUR J GALLAGHER RISK MGT SERVICES - INSURANCE CERTIFICATE (2)
ACORDr, CERTIFICATE OF LIABILITY INSURANCE of/16/2/ o 4 PRODUCER (303) 773-9999 FAX Arthur J. Gallagher & Co. - Denver 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 Col I ins P.O. Box 590 Ft Collins, CO 80522 INSURER& Genesis Insurance Company INSURERS: Lexington Insurance Company INSURER C: INSURER D: INSURER E: rnvcoAr_rc 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 kDD`L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (11HUDDIM POLICY EXPIRATION DATE (MM/DDIM LIMITS GENERAL LIABILITY YXB300654E 01/01/2004 04/15/2005 EACH OCCURRENCE $ 3,ON, 00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE nX OCCUR COV A - GENERAL LIAB. MED EXP (Any one person) $ A X X SIR $2SO,000 Per AUTO LIAB., LEL LIAB. PERSONAL &ADV INJURY $ B - PUBLIC OFFICIALS Occurrence COV GENERAL AGGREGATE $ 6,000,00 LAIBILITY GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ X POLICY PJECTRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR O CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STATU- rR EMPLOYERT LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNERIEXECUTIVE E.L. DISEASE - EA EMPLOYE $ OFFICER/MEMBER EXCLUDED? B yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT 1 $ OTHER 8752796 01/01/2004 04/15/2005 Per Occurrence: $100,000,000 Property -Special Form B lnkt Bldg & Pers Prop INCLUDES AUTOMOBILE Policy Deductible: $SO,000 PHYSICAL DAMAGE Vehicle Deductible: $100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS e: Fort Collins Capital Leasing Corporation is named Additional Insured as respects General Liability coverage regarding the Lease Agreement dated July 27, 2004 for Deicing Facility which terminates on June 1, 2023 and for Police Building which terminates on June 1, 2026. Fort Collins Capital Leasing Corporation 21SN. Mason Street PO Box 580 Fort Collins, CO 80S22 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 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE V Karen Graham/NMS _�� ACORD 25 (2001108) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(es) 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 26 (2001108)