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CORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE CERTIFICATE
OP ACOW. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) JORDA-2 03/11 09 PRODUCER - - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Front Range Insurance Group HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1100 Haxton Drive Suite 100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80525 Phone : 970-223-1804 INSURERS AFFORDING COVERAGENAIC # INSURED ~ INSURER A: The Hartford INSURER B: Pinnacol Assurance ,Jordan's Tree . Movingg & Maintenance, Inc. INSURER C: 1025,•Smithfield Drive INSURERD: Fort Collins CO 80524 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. - LTR NSR TYPE OF INSURANCE POLICY NUMBER. POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X GENERAL LIABILITY 34WNSR3887 03/10/09 03/10/10 PREMISEs(Eaoccu,ence) $300,000 CLAIMS MADE Fx_� OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 kCOMMERCIAL GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , OOO , OOO PRO LOC POLICY F1 JECT A X AUTOMOBILE LIABILITY ANY AUTO 34WNSR3887 03/10/09 03/10/10 COMBINED SINGLE LIMIT (Ea accident) $ 1 000 000 r X BODILY INJURY• (Per person) $ _ ALL OWNED AUTOS '=' _ SCHEDULED AUTOS - • '" X X BODILY INJURY (Per accident) - -' $ HIRED AUTOS NON-OWNED,AUTOS` • .. ,. :- .: . , •:. -- -(P r k PERTY dent) DAMAGE---- .` _ GARAGE LIABILITY " ' ` _. _- _AUTO ONLY= EA ACCIDENT $ T ANY AUTO,,- r T• c jOT1 fC R THAN EA ACC AUTO ONLY: AGG $ $ _. EXCESSIUMBRELLA LIABILITY - • �'� EACH OCCURRENCE $ OCCUR F_ICLAIMS MADE -AGGREGATE $ r _ $ $ DEDUCTIBLE $ RETENTION $ -- B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Af•!Y PROPRIETO R/PARTNER/EXECUTIVE ROPRl OFFICER/MEMBER EXCLUDED? 4040726 03/01/09 _ 03/01/10 X TORY LIMITS ER E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1000000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ 1000000 OTHER A Equipment 34WNSR3887 03/10/09 03/10/10 Install $10,000 Ded. $500 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - - the City of Fort Collins, its officers, agents and employees are named as additional insured with regards to general and auto Liability. CERTIFICATE HOLDER CANCELLATION CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO Box 580 Fort Collins -CO 80522 REPRESENTATIVES. AUTH EPRESENTATIVE 4CORD 25 (2001108) © ACORD CORPORATION 1988