Loading...
HomeMy WebLinkAboutLARIMER HUMANE SOCIETY - INSURANCE CERTIFICATE (14)ACORDM CERTIFICATE OF LIABILITY INSURANCE 06/16iz6) 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 Larimer Animal Protection & Control PO Box 272450 Fort Collins, CO 80527 INSURERA: Great American Insurance Co. INSURERS: Pinnacol Assurance INSURER C: INSURER D: INSURER E: CnVFRAGFS 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. V TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY PAC5373770 05/01/2006 05/01/2007 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 rA CLAIMS MADE rX OCCUR MED EXP (Any one person) $ 10,00( PERSONAL & ADV INJURY $ 1,000,00( GENERAL AGGREGATE $ 2,000,00( GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,00( POLICY PRO- JECT LOC AUTOMOBILE LIABILITY ANY AUTO CAP5373771 05/01/2006 05/01/2007 COMBINED SINGLE LIMIT (Ea accident) E 1,000,00 X BODILY INJURY (Per person) $ A ALL OWNED AUTOS SCHEDULEDAUTOS HIRED AUTOS NON-OWNEDAUTOS - - - - X BODILY INJURY (Per accident). $ X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY UMB5373772 05/01/2006 05/01/2007 EACH OCCURRENCE $ 1,000 00 X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 A $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND 4015370 10/01/2005 07/01/2006 X WC STATU- FR B EMPLOYER1UTY ANY PROPRIETORIETORIPARTNER/EXECUTIVE 4051370 07/01/2006 07/01/2007 E.L. EACH ACCIDENT $ 100 00 E.L. DISEASE - EA EMPLOYE $ 100,000 OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500 00 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT// SPECL4L OVISIONS ertificate Holder as Additional Insured as required by writtPRen contract per policy form. CFRTIFIr-ATF I4n1 r1F92 PAMPCI I ATInu SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE City of Fort Collins 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 P44 -X"r' ` " ACORD 25 (2001108) FAX: (970)224-6134 ©ACORD CORPORATION 1988