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HomeMy WebLinkAboutTCC CORPORATION - INSURANCE CERTIFICATE (2)A_CORD,m CERTIFICATE OF LIABILITY INSURANCE 9ii1/2008Y' PRODUCER (303)824-6600 FAX: (303)370-0118 Moody Insurance Agency, Inc. 3773 Cherry Creek North Drive THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 800 Denver CO 80209-3804 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Travelers Prop Cas Cc of 25674 TCC Corporation INSURER B:Pinnacol Assurance 41190 2900 W F Street INSURER C: INSURER D: Greeley CO 80631 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. T LIMIT H N AVE BEEN D C BY PAID MS. N"E INSR gDD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MNVDD/YV POLICY EXPIRATION DATE MWDD/YV LIMITS GENERAL LIABILITY EACH $ 11000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR DTCO5598C4841ND08 9/15/2008 9/15/2009 DAMAGE TO RENTED PREMISES Ea occurrence)$ 300, 000 MED EXP An one person) $ 5, 000 PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GETL AGGREGATE LIMIT APPLIES PER: X POLICY JEO LOC PRODUCTS COMP/OP AG $ 2,000,000 AUTOMOBILE LIABILITY ANY AUTO (Ea accideCOMBINEnt)INGLE LIMIT $ 11000,000 X A ALL OWNED AUTOS SCHEDULED AUTOS DT810559SC484TIL08 9/15/2008 9/15/2009 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GAR AGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAA $ ANY AUTO $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE E8QH OCCURRENCE $ 2,000,000 AGGREGATE S 2,000,000 A DEDUCTIBLE DTSMCUP559SC484TILOS 9/15/2008 9/15/2009 $ X RETENTION $10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- OTH- E.L. EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under 4021079 7/1/2008 7/1/2009 E.L. DISEASE EA EMPLOYEES 500,000 E. L. DISEASE - POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re: Soapstone Prairie Natural Area Shelters & Observatory, Bid: 6110. This certificate is subject to the terms, conditions, and exclusions of the policies. In the event of cancellation for non-payment of premium, a 10-day notice of cancellation will apply. City of Fort Collins Attn: Purchasing Division 215 North Mason St. 2nd Floor 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 ACORD 25 (2001/08) INS025 (0108).08a AUTHORIZED REPRESENTATIVE ........ _. _ __... N Eggink, ARM, CRIS/N © ACORD CORPORATION 1988 Page 1 of 2 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. ACORD 25 (2001/08) Page 2 of 2 INS025 (01o8).oea