The URL can be used to link to this page

Home My WebLink AboutALTERNATIVE TURF - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OF ID CH DATE (MMIDD YYYY) 1 ALTER-1 OS 30 08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LEIN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone: 970-635-9400 Fax:970-635-9401 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Coloratl Casualty xnauraooe Co INSURER B: Plnnacol Assurance Alternative Turf, LLC d}DS Turf Master INSURER C: 3327 Giddings Rd Fort Collins CO 80524 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 P LI Y EFFE TIVE DATE MM/DO P LI Y EXP'RATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE IC OCCUR CPP057004102 02/20/08 02/20/09 EACH OCCURRENCE $1,000,000 PREMISES(Eaomurenc) $100,000 MED EXP (Any one Person) $ 5,000 PERSONAL S ADV INJURY $1,000,000 GENERALAGGREGATE f2.,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY PECTRO LOC PRODUCTS - COMPIOP AGO $2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CPPO57004102 02/20/08 02/20/09 COMBINED SINGLE LIMIT (Eaac dent) $ 1000000 X BODILY INJURY (Per Person) $ BODILY INJURY (Per aobident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANYAUTO N/A AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ A EXCESS/UMBRELLA LIABILITY X I OCCUR CLAIMS MADE DEDUCTIBLE X RETENTION $1000O CPP057004102 02/20/08 02/20/09 EACH OCCURRENCE $1,000,000 AGGREGATE $ f $ is B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY4111868 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, Eescribe under SPECIAL PROVISIONS below 06/01/08 I 06/01/09 TORY LIMITS ER E.L. EACH ACCIDENT $SOOOOO E.L. DISEASE - EA EMPLOYEE $ 100000 I E.L. DISEASE - PULIDY LIMIT 1 $500000 OTHER N/A DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CITYFT3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN City of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SMALL Open Space -Natural Res. Dept. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR John Stokes P.O. BOX 580 REPRESENTATIVES. Ft. Collins CO 80522 AUT WA1EjIRESEfrATI j. C ACORD 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. SHELTER INSURANCE COMPANIES IR17 WEST BROADWAY COLUMBIA, MISSOURI 65218-0001 0"co:y 1-81)0-SHFLTIiR 001408 ODECO52708 #003561297 THE CITY OF FORT COLLINS PO BOX 580 =_ FORT COLLINS CO 80522-0580 all I III III Id1 I oil 11111111111 1111 11111111111 111111111 Rill POLICY NUMBER: 05-31-003561297-0008 Page THIS PAGE INTENTIONALLY LEFT BLANK Page ii