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SECURITY DOCUMENT DESTRUCTION - INSURANCE CERTIFICATE (5)
OP ID P ACORD CERTIFICATE OF LIABILITY INSURANCE SECURID DATE(MMIDD/YYYY) 04 02 10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 125 S Howes, 5th Floor P O Box 2226 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80522-2226 Phone:970=482-7747 Fax:970-484-4165 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA Mountain States Mutual 14648 INSURERB: Pinnacol Assurance Company 41190 SeCllrlty Document Destruction National Recycling Inc DBA INSURERC: INSURERD: PO BOX 2472 Ft Collins CO 80522-2472 INSURER E: CnVFRAnPR 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. ADD LTR INSR TYPE OF INSURANCE POLICY NUMBER P LI EFFE IVE DATE MM/DD/YY P LI Y EXPIRATI DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 PREMISES (Ea occurence) $100,000 A X X COMMERCIAL GENERAL LIABILITY CPP011394804 11/21/09 11/21/10 MED EXP (Any one person) $ 10,000 CLAIMS MADE X❑ OCCUR PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ Included POLICY PRO LOC JECT A AUTOMOBILE X LIABILITY ANY AUTO BAP011394804 11/21/09 11/21/10 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC AUTO ONLY: AGG $ ANY AUTO $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000 A X OCCUR F—ICLAIMSMADE UMB011394804 11/21/09 11/21/10 AGGREGATE $ 1,000,000 $ DEDUCTIBLE $ X RETENTION $ 10 , 000 B WORKER S COMPENSATION AND _ EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? _ _ _ _ _ 4108948 _ 10/01/09 10/01/10 X TORY_LIMITS_. . ER, - E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1, 000, 000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins is included as Additional Insured as respects the operations of the named insured. CERTIFICATE HOLDER CANCELLATION CITYFIO 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 City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR P O Box 580 Fort Collins CO 80522 REPRESENTATIVES. Ga"'� ACORD 25 (2001/08) © ACORD CORPORATION 1935