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HomeMy WebLinkAboutLARIMER HUMANE SOCIETY - INSURANCE CERTIFICATE (11)ACORD,M CERTIFICATE OF LIABILITY INSURANCE 7 DATE (MMIDOM 04/24/2006) PRODUCER (303) 776-5122 FAX (303) 776-5495 First MainStreet 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: Pinnacol Assurance INSURER C: INSURER D: INSURER E: CnVFRA6FR 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 ADD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE O OCCUR PAC5373770 05/01/2006 05/01/2007 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,00( MED EXP (Anyone person) $ 10,00( PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMPIOP AGG $ 2,000,00( A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON-OWNEDAUTOS CAP5373771 05/01/2006 05/01/2007 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Peraccident) $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ UMB5373772 05/01/2006 05/O1/2007 EACH OCCURRENCE $ 1,000,O0 AGGREGATE $ 1,000,000 $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED9 Ryes describe under SPECIAL PROVISIONS below 4015370 10/01/2005 07/01/2006 X I we STATTORY .0 OTH- E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYE $ 100,000 E.L. DISEASE - POLICY LIMIT I $ 50D 00 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS ertificate Holder as Additional Insured as required by written contract per policy form. f_FRTIFN`ATF WAI ng:P rAIJ!_FI I ATInM SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fort Col 1 i ns EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL Purchasing Department 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Attn : James O'Neil BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY PO Box 580 OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE Pat Deaver PAT i �°"""� ACORD 25 (2001/08) FAX: (970)224-6134 ©ACORD 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)