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HomeMy WebLinkAboutPOUDRE RIVER PUBLIC LIBRARY DISTRICT - INSURANCE CERTIFICATEClient#: 47846 POURII ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD1Y 03/19/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Flood & Peterson Ins., Inc. Corporate Mailing Address: P 9 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Box 578 Greeley, CO 80632. INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Travelers Insurance Company - Poudre River Public Library District 201' Peterson Fort Collins, CO 80524 INSURER B: Pinnacol Assurance INSURER C: INSURER D: 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. INSRDD LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EATE M/DDIYYE POLICY EXPIRATION LIMITS A GENERAL LIABILITY GP09313922 04/01/10 04/01/11 EACH OCCURRENCE $1 000 000 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $50OOO CLAIMS MADE � OCCUR MED EXP (Any one person) $5 000 PERSONAL & ADV INJURY $1 000 000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 POLICY JE� LOC A AUTOMOBILE LIABILITY ANY AUTO GP09313922 04/01/10 04/01/11 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS - BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS - PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY - AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ ANY AUTO $ AUTO ONLY: AGG A EXCESS/UMBRELLALIABILITY GP09313922 04/01/10 04/01/11 EACH OCCURRENCE s4000000 X1 OCCUR F1 CLAIMS MADE AGGREGATE s4,000000 $ $ DEDUCTIBLE $ X RETENTION $ 1 O 0OO B WORKERS COMPENSATION AND 4118811 04/01/10 04/01/11 TH- X ORY WC IIMIT FR EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $5OO OOO E.L. DISEASE - EA EMPLOYEE $50O 000 OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $500 OOO OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The certificate holder is named as an additional insured as their interest may appear in reference to the named insured's operations. (Excluding Workers Compensation) Policies contain a waiver of subrogation in favor of the additional insured. rIL,AIr City of Fort Collins 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 AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) 1 Of 2 #S516144/M516142 CAZ © ACORD CORPORATION 1988 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. ACORD 25-S (2001108) 2 of 2 #S516144/M516142