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HomeMy WebLinkAboutLARIMER HUMANE SOCIETY - INSURANCE CERTIFICATE (10)ACORDM CERTIFICATE OF LIABILITY INSURANCE 1 DATE 04/20/2005) PRODUCER (303) 776-5122.- FAX (303) 776-5495 First Mai nStreet "Insurance 512 4th Avenue P.O. Box 847 Longmont, CO 80502 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 Larimer Humane Society PO Box 272450 Fort Collins, CO 80527 INSURERA: Great American Insurance Co. INSURERS: INSURER C: INSURER D: INSURER E: (]I 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE fMMIDn8M POLICY EXPIRATION DATE IMMIDDIYYI LIMITS GENERAL LIABILITY PACS373770 05/01/200S 05/01/2006 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISE$ 100' 00 CLAIMS MADE � OCCUR $ 10,00( MED EXP (Any one person) A PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00( POLICY PRO- JECT LOC AUTOMOBILE LIABILITY CAPS373771 05/01/2005 05/01/2006 COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,000 BODILY INJURY ALL OWNED AUTOS A SCHEDULED AUTOS (Per person) $ BODILY INJURY HIRED AUTOS NON -OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per amident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO 1 OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY UMBS373772 05/01/2005 05/01/2006 EACH OCCURRENCE $ 1,000,00 X I OCCUR CLAIMS MADE AGGREGATE $ 11000,000 A $ DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND WC STATU- OTH- RY LIMITSFIR EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. DISEASE - GA EMPLOYE $ N yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER uto Physical Damage CAPS373771 05/01/2005 05/01/2006 As scheduled A DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ertificate Holder as Additional Insured as required by written contract per policy form. City of Fort Collins Purchasing Department Attn: James O'Neil 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 10 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 � Pat Deaver/PAT IC -tee --1— ACORU 25 (2001108) rAA: ly/U)LL4-b154 ©ACORD CORPORATION 1988