HomeMy WebLinkAboutCFG CONCESSIONS - INSURANCE CERTIFICATE (4)OCT 18 2004 14:40 FR TO 2216707 P.01i01
1
CERTIFICATE OF LIABILITY INSURANC j °"10/14 as
PRODUCER
Brown 6 Brown Inc - Ft Collins
125 S Howes, Sth Floor
P 0 Box 2226
Fort Collins CO 80522-2226
Phone: 970-482-7747 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.
04 INSURERS AFFORDING COVERAGE
INSURED
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INSURERX Pinnacol Assurance
NSURER It
INSURER C'
INSURERD
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INSURER &
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 PSRTAIN, THS INSURANCE AFFORDED BY THE POLICIES DESCRIBED NOON IS SUBJECT TO ALL THE TEAMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICES. AQGRSGATS LIMITS 0401SM MAY HAVE BEEN REDUCED BY PAID CLAIMS.
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TYPE OF INSLIRANGfi
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DATE
MARS ...
GENERAL LIABILITY
EACH COOLIMENCE
S
FIRE DAMAGE (Any orM rm
S
COMMERCIAL GENERAL LAJULMY
CLAIMS MADE OCCUR
MED Dp ArM Dora pawn)
S
PERSONAL A ADV WAIRY
S
_
_
GENERALAGGREGATE
S .•-_'.
GENL AGGREGATE LIMIT APPLIES PER:
PRODUCTS -COMPLOP AGO
S
POLICY SEJ LOC
AUTOMOBILE
LIABRRY
ANY AUTO
COMBINED
E SINGLE LIMIT
-
-
ALL "ED AUTOS
SCHEDULED AUTOS
SODILYINJURY
(Pwprwn)
S
-
HIRED AUTOS
MON-OWNED AUTOS
BODAY INJURY
(par acclam)
S
PROPERTY DAMAGi
(Pxaeddr1
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GARAGE LIABILITY
AUTO ONLY-EAACCIOENT
S
ANY AUTO
EA ACC
OTHERTHAN
AUTO ONLY AW
S
1xCESS LIABILITY _
.� OCCUR CLAIMS MADE
EACH OCCURRENCE
AGGREGATE—�._..,.,.
S
.,_ _............... _...
s
—T--
s
.... DEDUCTIBLE
RETENTION
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A
WORMERS COMPENSATION AND
EMPWVERVLIAML"Y
,ram
10/15/04
10/15/03
x TORY LIMITS ER
E.L. EACH ACCIDENT
$ 100000
El. DrefFASE-EA EMPLOYeq
5100000
ELOISEASE•POUCYUMIT
s500000
OTHER
DESCRIPTION OF OPSRATIONS1LOCA'ffi5N94m=LUSION8 ADDED BY ENDORSEMENTIEPECULL PROMS16
FAX 221-6707
City of Fort Collins
Purchasing Division
Attn: David Carrey
PO Pox 580
Fort Collins CO 80522-0580
CITYDIV SHOULD ANY OF THE ABOVE OESCRIBED POLIOMS BE OMMELLEO B�EF,OWRE THE EAFPVLTH)L
DATE YHEREOF, THE ISSUING INSURER WILL ENOEAVORTO MAR-XQ—DAYSYNRTTTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEPt BUT FAILURE TO 00 SO MALL
BMOSE N0OBLIRATION OR LIABILITY OF ANY KIND UPON THE NSURK ITS AGENTS OR
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