HomeMy WebLinkAboutCITY OF FORT COLLINS LEASING DEICING POLICE BUILDI - INSURANCE CERTIFICATEACORDM CERTIFICATE OF LIABILITY INSURANCE
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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 Collins
P.O. Box 580
Ft Collins, CO 80522
INSURERA: Genesis Insurance Company
INSURERS: Lexington Insurance Company
INSURERC
INSURER D:
INSURER E:
CAVFRAC7FS
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
IkDDL
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
GENERAL LIABILITY
YXB300654F
04/15/2005
04/1S/2006
EACH OCCURRENCE
$ 3,000,00
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
PRFMIRFS IF,
$
CLAIMS MADE OX OCCUR
COV A - GENERAL LIAB.
MED EXP (Any one person)
$
A
X
X SIR $250,000 Per
AUTO LIAB., LEL LIAB.
PERSONAL& ADV INJURY
$
B - PUBLIC OFFICIALS
Occurrence CO
GENERAL AGGREGATE
$ 6,000,00
LAIBILITY
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$
X POLICYPJECT RO- LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea aoddent)
$
X
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTYDAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY. AGG-
$
ANY AUTO
$
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
WCSTATU- EIM
LIMEMPLOYERS'
LIABILITY
ANY PROPRIETORIPARTNERIEXECU-17YE
OFFICER/MEMBER EXCLUDED?
E.L. EACH ACCIDENT
$
El, DISEASE-FJ EMPLOYE
$
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$
B
OTHER
ropertSpecial Form
lnkt Bldg & Pers Prop
8754017
INCLUDES AUTOMOBILE1
PHYSICAL DAMAGE1
04/1S/200S
04/15/2006
I
Per Occurrence: $100,000,000
Policy Deductible: $50,000
Vehicle Deductible: $100,000
DESCRIPTION OF OPERATIONS i LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I 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
215N. Mason Street
PO Box S80
Fort Collins, CO 80522
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 Y
Karen Graham/NMS
ACORD 25 (2001/08) CACORD 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)