HomeMy WebLinkAboutST JOSEPH CATHOLIC CHURCH - INSURANCE CERTIFICATECertificate of Coverage Date:6/5/2008
certificate Holder
This Certificate is issued as a matter of information only and
Archdiocese of Denver
1300 S. Steele Street
Denver, CO 80210
confers no rights upon the holder of this certificate. This certificate
does not amend, extend or alter the coverage afforded below.
Company Affording Coverage
THE CATHOLIC MUTUAL RELIEF SOCIETY
10843 OLD MILL RD
OMAHA, NE 68154
Covered Location
St. Joseph Catholic Church
300 W. Mountain Avenue
Fort Collins, CO 80522
Coverages
This is to certify that the coverages listed below have been issued to the certificate holder named above for the certificate
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 coverage afforded described herein is subject to all the terms, exclusions and
conditions of such coverage. Limits shown may have been reduced by paid claims.
Type of Coverage
Certificate Number
Coverage Effective
Date
Coverage Expiration
Date
Limits
Property
Real & Personal Property
General Liability
General Aggregate
Products -Cam p/OP Agg
❑✓ Occurrence
Personal & Adv Injury
Claims Made
8858
7/l/2008
7/1/2009
Each Occurrence
500,000
Fire Damage (Any one fire)
Med Exp (Any one person)
Excess Liability
8858
7/1/2008
7/l/2009
Each Occurrence
1,000,000
Other
Each Occurrence
Description of0perations/Locations/Vehicles/Special Items
Coverage only extends for claims arising out of St. Joseph Catholic Church, holding their Parish and School Picnic on September 14,
2008, being held at the 100 block of North Howe Street.
Holder of Certificate
Cancellation
Additional Protected Person(s)
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
Should any of the above described coverages be cancelled
before the expirationdate thereof, the issuing company will
endeavor to mail days written notice to the holder of
certificate named to the left, but failure to mail such notice shall
impose no obligation or liability of any kind upon the company,
its agents or representatives.
Authorized Representative
0018002359
ENDORSEMENT
(TO BE ATTACHED TO CERTIFICATE)
Effective Date of Endorsement 9/14/2008 Charge Credit
Cancellation Date of Endorsement W57M
Certificate Holder Archdiocese of Denver
1300 S. Steele Street
Denver, CO 80210
Certificate No. 8858 of The Catholic Mutual Relief Society is amended as follows
SECTION II - ADDITIONAL PROTECTED PERSON(S)
It is understood and agreed that Section II - Liability (only with respect to Coverage D - General
Liability, Coverage F - Medical Payments to Others and Coverage H - Counseling Errors and Omissions) is
amended to include as an Additional Protected Person(s) members of the organizations shown in the
schedule, but only with respect to their liability for the Protected Person(s) activities or activities they
perform on behalf of the Protected Person(s).
It is further understood and agreed that coverage extended under this endorsement is limited to and applies
only with respect to liability assumed by contract or agreement; and this extension of
coverage shall not enlarge the scope of coverage provided under this certificate or increase the limit of
liability thereunder, Unless otherwise agreed by contract or agreement, coverage extended under this
endorsement to the Additional Protected Person(s) will not precede the effective date of this certificate of
coverage endorsement or extend beyond the cancellation date.
Schedule -ADDITIONAL PROTECTED PERSON(S)
City of Fort Collins
PO Box 580
Fort Collins, CO 80522-0580
Remarks: Coverage only extends for claims arising out of St. Joseph Catholic Church, holding their
Parish and School Picnic on September 14, 2008, being held at the 100 block of North
Howe Street.
PKS-122 (1-99)
47Au epresentative