No preview available
HomeMy WebLinkAbout113967 PROJECT SELF-SUFFICIENCY - INSURANCE CERTIFICATEClient#: 35461 f]Tiia3 ACORD.., CERTIFICATE OF LIABILITY INSURANCE DATE 4/15/(0800/vrvv) PRODUCEk THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Insurance Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4821 Wheaton Drive P O Box 270370 HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins, CO 80527 INSURERS AFFORDING COVERAGE NAIC # INSURED Project Self -Sufficiency 375 W. 37th St., Suite 150 Loveland, CO 80538.2261 INSURERA: Ohio Casualty CO INSURER B:INSURER C: INSURER D: INSURER E: 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 INSRE TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DDIYY POLICY EXPIRATION DATE MMIDDMI LIMITS A GENERAL LIABILITY BKO52256750 04/25/08 04/25/09 EACH OCCURRENCE $1006000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $100000 MED EXP (Any one person) $1 D 000 CLAIMS MADE O OCCUR PERSONAL &ADV INJURY $1,000,000 GENERAL AGGREGATE $1 0-0-0- 000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $1000000 POLICY PRO- LOC PC AUTOMOBILE LIABILITY ANY AUTO SINGLE LIMIT COMBINED accident) (E $ BODILY I (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ A GARAGE LIABILITY BNO0852256750 04/25/08 04/25/09 AUTOONLY- EAACCIDENT $1,000,000 EA ACC AUTO ONLY: AGO $1,000,000 ANY AUTO X Owned/Non-Owned $1,000,000 EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR F—ICLAIMS MADE DEDUCTIBLE $ RETENTION It _ _ WORKERS COMPENSATION AND STATU- OTH- TWO EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The certificate holder is named as an additional insured as their interest (See Attached Descriptions) City of Fort Collins P.O. 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 _30_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR AUTHORIZED REPRESENTATIVE d•-16gnek IV P.e...dm.."S00 ,1 ACORD 25 (2001108) 1 of 3 #S412415/M412412 evn n Acnwn nnRDnCATlnrd 4000 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. Acoku 25-6 (2uu11us) 2 of 3 #S412415/M412412 DESCRIPTIONS (Continued from Page 1) 1 may appear in reference to the named insured's operations in regards to the use of the Repair Shop. AMS 25.3 (2001/08) 3 of 3 #S412415/M412412