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HomeMy WebLinkAboutBOULDER COUNTY COLORADO - INSURANCE CERTIFICATEACORd CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/31 /2009 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION MARSH USA INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1225 17TH STREET, SUITE 2100 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR DENVER, CO 80202-5534 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 4022 52-00124-G AW C-10-11 INSURED BOULDER COUNTY COLORADO 2025 14TH STREET, FIRST FLOOR BOULDER, CO 80306 INSURERS AFFORDING COVERAGE NAIC # INSURER`A: Insurance Company Of The State Of PA 19429 INSURER B: N/A N/A INSURER C: INSURER D: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS LTR ADD' INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE I DATE (MWt)DfYYYY) POLICY EXPIRATION DATE (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE INCLUDED DAMAGE TO RENTED PREMISES Ea occurrence $ INCLUDED A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR 6907967 01/01/2010 01/01/2011 MED EXP (Any one person) $ NONE X $250,000SIR PERSONAL & ADV INJURY $ INCLUDED GENERAL AGGREGATE $ 5,000,000 GENERAL AGGREGATE APPLIES PER X POLICY F7 JECT LOC PRODUCTS - COMP/OP AG 5 000 000 AUTOMOBILE LIABILITY ANY AUTO EOacc COMBINEDSINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS _ BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE (Peraccident) ' $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ _ ANY AUTO _ OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR CLAIMS MADE DEDUCTIBLE - $ $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY WC STATU- OTH- .L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? - DISEASE - EA EMPLOYE $ (Mandatory.L. in NH) ff yes, describe under SPECIAL PROVISIONS below .L. DISEASE - POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR TO THE GENERAL LIABILITY POLICY. CERTIFICATE HOLDER SEA-001531715-03 CANCELLATION CITY OF FORT COLLINS ATTN: PURCHASING DIVISION PO 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 REPRESENTATIVES. Sharon A. Hammer .+... r%u zz) © 1998-2009 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD 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 This Certificate of Insurance 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.