HomeMy WebLinkAboutLARIMER HUMANE SOCIETY - INSURANCE CERTIFICATE (4)12/10/2003 15:52 9703779513 LARIPIER HUMAHE SOCIT PAGE 03
-A=Aw". CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DLYYYyy,
F First rstR (303)776-5122 FAX (303)776-S495 12/10/2008
MainStreet Insurance THIS CERTIFICATE IS ISSUED
AS A MATTER OF INFORMATION
S12 4th Avenue ONLY AND CONFER$ NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOE$ Nor AMEND, EXTEND OR
P.O. Box 847 ALTER THE COVERAmEAFFdRDEd DYTHE POLICIES BELOW.
Longmont, CO 80502 INSURERS AFFORDING COVERAGE
+SVRFO LarTmor umane 5oc et NAIC#
Larimer Animal Protection and Control INSURER A: Great American Insurance Co.
$137 South College Avenue INSURER A'
Pinnacol Assurance
Fort Collins, Colorado 8OS02S INSURER 0:
--�.�=�wlou ngLVW AVE HBEEN ISSUED _
.... ED TO THE iNAI IRpn I,Ie,.,en .o..,,� �.._ _.......
MAY PERTAIN,
POLICIES.
THE INSURANCE AFFORDED
AGGREGATE LIMITS SHOWN
aY THE POLICIES IDESCRIBEO
POLEEN CIES D RI ED
HEREIN DOCUMENTS 5 B,I CT
HCLAIMS,
HPEGf
TO
CERTIPICATe MAY G
ISSUED
INSR P
MAY HAVE REDUCED
ALL THEYTEgMS,
EXCLUSIONS A 0 CONDITIONS OF R
TYPEOFIN$URANCE
LABR
POLICY NUMBER
POU EFFFC7IVE
POLICY PIA OGENERAL
X
COMMERCIAL GENEkAL LIADIUTY
PACS3 73 77004
'
05/Oj/2QQ8
QS/0j/2009
41MIis
EACN OCCURRENCE §
CLAIMS MADE a OCCUR
DAMAGE TO REIJTED 1 000 000
Tme $
A
-p-@E,nlSc E� 100 DO
MEOEXP(Anyon- PCMNI) S 10 000
PERSONAL ADV INJURY S 1 000 D0
OEFIt
AGGREGATE LIMITAPPLIES PER:
GENEPALAGGREGATE S 2 000,00
POLICY �T LOC
PRODUCTS-COMPIOPAGG S 2 DOD OOO
AUTOMOeILELIAOILnY
CAP537377j04
OS Ol/20p$
/
OS101/2p09
X
ANYAUTO
COMBINED SINGLE LIMIT
ALL OWNED AUTOS
(Ea acrdem) $
l,ppa 000
A
SCHEDULED AUT09
BODILY INJUkY
X
HIRED AUTOS
(P�P.Mon) S
X
NON.OWNEOAUTOS
BODILY gyJURY �w�1
x
(Per nccmmD
(R&a VgnIOAMAGE §
4ARAOELIABILITY
ANYAUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
S
ExcessluMeREUA uaF1uTY
UMBS373772tl4
OS/01/2008
05/01/2009
AUTO ONLY: AEG
§
X OCCUR �CLNMS MADE
EACH O=URRENCE
x j,p00 000
- 000 0
A
AGGREGATE
x i
j000 000
DEDUCTIBLE
RETENTION g
$
WORKER$ COMPENSATION AND
4015370
07/01/2009
07/01/2009
X %c'D sTATU� OTH.
EMPLOYER$'UAFILJTY
B ANY
4015370
07 /01 /2007
07/01/2008
E.L. EACH ACCIDENT
$ 100, 000
OFMCERIMEMBER EXCLUDEOO?�UTIVE
E.UDISEASG.EAEMPLDYE
f 100, 0QQ
R y�x duMbe under
SPECIAL PROVISIONSbtlmv
E.L.OISEASE-POLICYUMIT S Soo 000
OTHER
DE9Cryw� ONOFOPERATION91LOCATI0eSIVE1yiICLESI1 EXCLUSION$ ADDED BY ENDOPSEMenT/BpECI LPROYI$]ONS
ertiticate Holder as Additional Insured
as required ny wr tten contract per policy form.
City of Fort Collins
Purchasing Department
Attn: lames O'Neil
P 0 Box 580
Fort Collins, CO 80522
ACOltbas T9nni Mal FAX: (970)2
I..CLLH l lllry
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES RE CANCELLED OEFORE THE
E><PIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR To MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMEDTO THE LEFT,
BUT FAJLURETO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UA014nY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED RE PRESENTATIVE
Shellv Sawver/SHELLY