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HomeMy WebLinkAboutTHE FACE OF FORT COLLINS - INSURANCE CERTIFICATEACORDDATE (MM/DD/Y M CERTIFICATE OF LIABILITY INSURANCE 02/08/2010YYY) PRODUCER 970.223.0924 FAX 970.267.2231 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Colorado BW Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1075 W Horsetooth Rd, Ste 106 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins, CO 80526 INSURERS AFFORDING COVERAGE NAIC # INSURED THE FACE OF FORT COLLINS INSURER A: Colorado Casualty Insurance 41785 158 S COLLEGE AVE INSURERS: Pinnacol Assurance 41190 FORT COLLINS; 'CO 80524 INSURERC: INSURER D: I INSURER E: COVERAGES 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 LTR ADDT NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM/DD/YYYY LIMITS GENERAL LIABILITY BOP8562841 01/28/2010 01/28/2011 EACH OCCURRENCE $ 1,000,000 COMMERCIAL GENERAL LIABILITY AMAGE TO RENTED PREMISES Ea occu ence $ 50,000 CLAIMS MADE 1-il OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 A X GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY ROECT JPLOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) BODILY INJURY $ ALL OWNED AUTOS SCHEDULED AUTOS (Per person) BODILY INJURY $ HIRED AUTOS NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ I - (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMSMADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION 4092894 06/01 2009 06/01/2010 TORY LIMITS ER AND EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 100,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE� E.L. DISEASE - EA EMPLOYEE $ 100,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The certificate holder is named as an additional insured. IraA:iilT�r*T!.Vi;z:ri7xa]zu arkW4IW1%III W SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Attn • Rhonda Henson NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 281 North College Avenue IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO Box 580 REPRESENTATIVES. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE Johna Moors ACORD 25 (2009/01) FAX: 221.6378 ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD