HomeMy WebLinkAboutLARIMER HUMANE SOCIETY - INSURANCE CERTIFICATE (13)DATE
ACORD,M CERTIFICATE OF LIABILITY INSURANCE 1 06/16/20061
PRODUCER (303) 776-5122 FAX (303) 776-5495 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
First MainStreet Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
512 4th Avenue
P.O. Box 847
Longmont, CO 80502
INSURED Larimer Humane Society
Larimer Animal Protection & Control
PO Box 272450
Fort Collins, CO 8OS27
COVERAGES
INSURERS AFFORDING COVERAGE
INSURERA: Great American Insurance
INSURERS: Pinnacol Assurance
INSURER C:
INSURER D:
INSURER E:
NAIC #
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
kDWL
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
POLICY EXPIRATION
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR
PAC5373770
05/01/2006
05/01/2007
EACH OCCURRENCE
$ 1,000,000
DAMAGE TPRFMI O RENTED
$ ZOO OO
MED EXP (Any one perwn)
$ 10,000
PERSONAL & ADV INJURY
S 1,000,000
GENERAL AGGREGATE
S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY JECTPRO LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
CAPS373771
05/01/2006
05/01/2007
COMBINED SINGLE LIMIT
(Ea accident)
$
1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Par accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
A
EXCESSIUMBRELLALIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
UMB5373772
05/01/2006
O5/01/2007
EACH OCCURRENCE
$ 1,000 00
AGGREGATE
$ 1,000,000
$
$
$
B
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, dewdbe under
SPECIAL PROVISIONS below
4015370
4051370
10/01/2005
07/01/2006
07/01/2006
07/01/2007
TH-
X I WC Y LIMITSSTATU- OFR
E.L. EACH ACCIDENT
$ 100,000
E.L. DISEASE - EA EMPLOYE
$ 100,000
E.L. DISEASE - POLICY LIMIT
I $ 500,00
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I 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 580
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 44
ACORD 25 (2001108) FAX: (970)224-6134 OACORD CORPORATION 1988