HomeMy WebLinkAboutROCKY MOUNTAIN INNOVATION - INSURANCE CERTIFICATEClient# 49137
RMINN
ACORD- CERTIFICATE OF LIABILITY
INSURANCE
DATE
4/8/08M/DOmyY)
PRODUCER`
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
P O Box 270370
Fort Collins CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Rocky Mountain Innovation Initiative I
200 W Mountain Ave Suite C
Fort Collins, CO 80521
INSURER Auto Owners Insurance Group
INSURER B Philadelphia Insurance Companies
INSURER C
INSURER D
INSURER E
COVERAGES
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
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
PDAITV EXPIRATION
LIMITS
A
GENERAL LIABILITY
4755119500
03/01/08
03/01/09
EACH OCCURRENCE
$2 000 000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$50000
MED EXP (Any one person)
$5 000
CLAIMS MADE a OCCUR
PERSONAL S ADV INJURY
$2 000 000
GENERAL AGGREGATE
$2 000 000
GEN L AGGREGATE LIMIT APPLIES PER
PRODUCTS COMP/OP AGG
s2,000,000
1-1 POLICY JECTPRO LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED
(a acadennt)SINGLE LIMIT
$
BODILY INJURY
(Per parson)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Peraccident)
$
HIRED AUTOS
NON OWNED AUTOS
PROPERTY DAMAGE
(Per accideM)
$
GARAGE LIABILITY
AUTOONLV EAACCOENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY AGO
EXCESS/UMBRELLA
LIABILITY
OCCUR CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
E
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
WCSTATU OTH
IR
EMPLOYERS LIABILITY
EL EACH ACCIDENT
$
ANV PROPRIETOWPARTNER/EXECUTIVE
EL DISEASE EAEMPLOYEE
$
OFFICERIMEMBER EXCLUDED?
It yes describe under
SPECIAL PROVISIONS below
EL DISEASE POLICY LIMIT
E
B
OTHER D & O Liab
03/01/08
03/01/09
$1 000 000 Limit
IPHSD311964
$1 000 Deductible
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BV ENDORSEMENT I SPECIAL PROVISIONS
Certificate holder is named as additional Insured as owner/lessor
as regards the following location
Loc# 1 200 W Mountain Ave Suite C Fort Collins CO
City of Fort Collins
300 Laporte Ave
Fort Collins CO 80521
LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ DAYS WRITTEN
E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
IE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
AUTHORIZED REPRESENTPPTIVE
Fl0004 'r l/t.f�ScnJ I Z..JC
ACORD 25 (2001/08) 1 of 2 #S411487/M411486
SYC 0 ACORD CORPORATION IQR$
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
Z OTZ IM47740HM479466