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Home My WebLink AboutGROWLING BEAR - INSURANCE CERTIFICATE (4)ACORD CERTIFICATE OF LIABILITY INSURANCE DATE,MMIDDM04 OP ID R GROWL-3 07 21 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Linden/Bartels & Noe Agency FC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Uni ' t A ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1614 Oakridge Drive, Fort Collins CO 80525 Phone:970-229-9304 Fax:970-229-1398 23 Oling AeQaQr Co., Inc. 4thGreeley CO eb631 INSURERS AFFORDING COVERAGE INSURERn Employers Mutue INSURER B: Pinnacol AssurB INSURER C: INSURER D: INSURER E: NAIC # VVYGfV\ 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. NbK LTR NS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDJYY POLOVEMOUTFOIT DATE MMIDDlYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X� OCCUR X Blanket Add r 1 OD9652205 07/31/04 07/31/05 EACH OCCURRENCE $ 1 , 000 , 000 PREMISES (Ea oecurence) $100,000 MED EXP (Any one person) s5,000 PERSONAL & ADV INJURY $ 1 , 000 , 000 Insured GENERAL AGGREGATE s2,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X jEC LOC PRODUCTS -COMP/OP AGG s2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS OE9652205 07/31/04 07/31/05 4 COMBINED SINGLE LIMIT (Ea accident) $ 1, 000 , 000 X BODILY INJURY (Per person) $ J U L 2 `3 20 X BODILY INJURY (Per exidera) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO 1 CITY RISK OF FORT C- MANAGE L.LINS ENT AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC AUTO ONLY: AGG $ $ A EXCESSIUMBRELLA LIABILITY X I OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ OJ9652205 07/31/04 07/31/05 EACH OCCURRENCE s2,000,000 AGGREGATE $2,000 000 $ $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? Des describe under SPECIAL PROVISIONS below 1436910 07/01/04 07/01/05 X TORY LIMITS ER E.L.EACH ACCIDENT s500,000 E.L. DISEASE - EA EMPLOYEE $500,000 E.L. DISEASE -POLICY LIMIT $ 500 000 A OTHER Installation Floater OC9652205 07/31/04 07/31/05 I Any 1 Loc $1,500,000 Ded $250 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS RE: Lincoln Center HVAC 6 Roof Repair. Certificate holder is named as additional insured with respects general liability. VCR I IrIVM 1 C R V LYCR CITYFTC 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 DO SO SHALL City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 215 North Mason REPRESENTATIVES. Fort Collins CO 80525 AU RQ REPRES G ACORD 25 (2001108) © ACORD CORPORATION 1988 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID R DATE (MMID1I/04 GROWL-3 07 21 04 Linden/Bartels & Noe Agency FC 1614 Oakridge Drive, Unit A Fort Collins CO 80525 Phone:970-229-9304 Fax:970-229-1398 Growling Bear Co., Inc. Greeley CO 80631 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 # INSURER A: to ers Mutual INSURERS: Pinnacol Assurance INSURER C: INSURER D: INSURER E: cvvew+r;ts 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 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. NbK LTR NSR TYPE OF INSURANCE POLICY NUMBER PATE MMID DATE MMID LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X❑ OCCUR X Blanket Add Il OD9652205 07/31/04 07/31/05 EACH OCCURRENCE $ 1 , 000 , 000 UAMUt I U KLN I LU$100 PREMISES (Ea 000urence) r 000 MED EXP (Any one person) $ 5 , 000 PERSONAL BADVINJURY $ 1 000.000 Insured GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X jEC ELOC PRODUCTS - COMP/OP AGG $ 2 , 000 , 000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS OE9652205 07/31/04 f 'y ,F �\(13{S�«�N 07/31/05 �,,1 11�1`,(\'/\J n (,OO� COMBINED SINGLE LIMIT (Ea aaident) $ 1 , 000 , 000 X BODILY INJURY (Per $ LY INJURY BODILY NJ (Per accident) $ X X PROPERTY DAMAGE (Per accident) $ GARAGE UABILITY ANY AUTO �]`]� �R�- l� ` `�]j]wI]�S ]"-F'1�OTHER � AUTO ONLY -EA ACCIDENT $ AUTO ONLY: EA $ A EXCESSIUMBRELLA LIABILITY X OCCUR 0CLAIMSMADE DEDUCTIBLE RETENTION. $ OJ9652205 07/31/04 07/31/05 EACH OCCURRENCE s2,000,000 AGGREGATE s2,000,000 S $ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 1436910 07/01/04 07/01/05 _ X TORY LIMITS I I ER E.L. EACH ACCIDENT s500,000 E.L. DISEASE - EA EMPLOYEE $500, 000 E.L. DISEASE - POLICY LIMB s50D 000 A OTHER Installation Floater OC9652205 07/31/0 007/31/05 Any 1 Loc $1,500,000 Ded $250 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ALL Operations - All Locations CITYFTC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WALL 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 LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Fort Collins 215 North Mason REPRESENTATIVES. Fort Collins CO 80525 AU REPRES C� F_Tda7:113 k: