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Home My WebLink AboutTRIBURON - INSURANCE CERTIFICATEACORD„A CERTIFICATE OF LIABILITY INSURANCE DATE (MMIOD/YYYY) 9/4/2008 PRODUCER (415) 874-7100 FAX: (415) 874-7199 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Equity Rik Partners, Inc. 1' sar ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR License No. OD21146 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 101 Montgomery Street, 14th Fl San Francisco CA 94104 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA:ACE American Insurance 22667 INSURERB National Union Fire Ins. 19445 Tiburon, Inc. 6200 Stoneridge Mall Road INSURER c: Wes tches ter Fire 21121 INSURERUIns. Co. of the State of 19429 Suite 400 Pleasanton CA 94588 INSURER E: OVERAGES 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. INSR ADD'L p TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD/YY POLICY EXPIRATION DATE MMIDDNY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 DAMAGE PREMISSS EEa Ea occurrence) $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR G23866791 9/l/2008 9/1/2009 MED EXP (Any oneperson) $ Excluded PERSONAL ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 RI- X LOC 17 POLICY IECT AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ 11000,000 X BODILY INJURY (Per person) $ B ALL OWNED AUTOS SCHEDULED AUTOS CA4576404 9/l/2008 9/l/2009 X BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS X X PROPERTY DAMAGE (Per accident) $ Comp Deductible-$250 X1 Coll Deductible-$500 GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHERTHAN EA ACC S ANY AUTO $ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY X OCCUR CLAIMS MADE EA H E $ 10,000,000 AGGREGATE $ 10,000,000 $ G22056141001 9/l/2008 9/1/2009 $ C DEDUCTIBLE Is X RETENTION S 10,000 1 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE No one excluded from EL OR 4883930 T ATU- WCV MITST91 X I E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYEE$ 1,000,000 B OFFICERJMEMBER EXCLUDED? If yes, describe under CA 4883929 9/l/2008 9/1/2009 E.L. DISEASE -POLICY LIMIT $ 1,000,000 SPECIAL PROVISIONS below AOS 4883928 OTHER Limit 3,000,000 B Errors & Omissions 012116119 9/1/2008 9/1/2009 Retention 250,000 DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS THE CITY AND COUNTY, THEIR OFFICERS, OFFICIALS, EMPLOYEES, AGENTS, AND VOLUNTEERS ARE INCLUDED AS ADDITIONAL INSUREDS AS RESPECTS WORT( PERFORMED BY OR ON BEHALF OF THE NAMED INSURED. CITY CLERK'S OFFICE 300 LAPORTE AVENUE P.O. BOX 580 FORT COLLIN, CO 80522-0580 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 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE %CORD INS025 (DiDe).oea AUTHORIZED Marcon/'PHOMP ,7 ACOR❑ 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. ... MU co kcuu I/U0) INS02510 Bp8a Page 2 of