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HomeMy WebLinkAboutUNITED WAY OF LARIMER COUNTY - INSURANCE CERTIFICATE (2)ACORD. CERTIFICATE OF LIABILITY INSURANCE D 5/0801vvvr) 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 United Way of Larimer County 424 Pine Street#102 INSURERA: Philadelphia Insurance Companies INSURERS: Pinnacol Assurance Fort Collins, CO 80524 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 T111S 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 DATE MMIDD/VV POLICY EXPI RATION DATE MMIDD/YY LIMITS A GENERAL LIABILITY PHPK314715 07/01/08 07/01/09 EACH OCCURRENCE $1000000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 51 OCCUR DAMAGE TO RENTED PR MI .Uri $100 000 MED EXP (Any one person) $5 000 PERSONAL &ADV INJURY $1000000 GENERAL AGGREGATE $2 000 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGO $2009000 POLICY PRO-JECT LOG A AUTOMOBILE LIABILITY ANY AUTO PHPK314715 07/01/08 07/01/09 COMBINED SINGLE LIMIT (Ea accident) $1,000,ODD BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X X BODILY INJURY (Peraccid.dt) $ [AIRED AUTOS NON OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGO A EXCESS/UMBRELLA LIABILITY PHUB239834 07/01/08 07/01/09 EACH OCCURRENCE $1000000 OCCUR F—ICLAIMS MADE AGGREGATE $1 00D 000 $ $ DEDUCTIBLE $ X RETENTION $ 10000 B WORKERS COMPENSATION AND 1139172 07/01/08 07/01/09 X wcsTATu- orH- EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT 5500,000 E.L. DISEASE - EA EMPLOYEE $500,000 OFFICER/MEMBER EXCLUDED? If yes, describe end., SPECIAL PROVISIONS below EL.DISEASE - POLICY LIMIT $500,000 A OTHER Property PHPK314715 07/01/08 07/01/09 Bus. Personal Property $200,000 special form DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate Holder is listed as Additional Insured as their interests may appear regarding: Emergency Shelter for the homeless during winter months. City of Fort Collins: Attn: Jim O'Neil, City Purchasing Dept. 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 ACORD 25 (2001/08) 1 of 2 #M418974 KXH © ACORD CORPORATION 198E 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. AUUKU zba tzuuvual 2 of 2 #M418974