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HomeMy WebLinkAboutLARIMER HUMANE SOCIETY - INSURANCE CERTIFICATE (5)ACO-R- CERTIFICATE OF LIABILITY INSURANCE • TE 04/29/20 PRODUCER (303) 776-5122 FAX (303) 776-5495 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION First Mai nStreet Insurance 512 4th Avenue 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 847 Longmont, CO 80502 INSURERS AFFORDING COVERAGE NAIC # INSURED Larimer Humane -Society.. _ INSURER A: Great American Insurance Co. 5,137, South College Avenue INSURERB: Great American Assurance Co'. ., - -• ' -• I Fort,C611-ins, CO 80525 __�.. INSURERC: Great American'All`iance Ins.. Co-; ------.— INSURERD: Pinnacol Assurance; 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 DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE 1MM/DDNYI POLICY EXPIRATION DATE (MM/DDNYI LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE r�] OCCUR PAC537377005 05/01/2009 07/01/2010 - EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED'REM $ 100,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 7 OOO, UOO GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC PRODUCTS - COMP/OP AGG $ - 2,000,000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS _.._. -"`- ""-'•""`-''••^- CAP537377105 05/01/2009 07/01/2010 _ . .. COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) X PROPERTY DAMAGE (Per accident) GARAGE•LIABILITY ANY AUTO . _ j.`.•.t'..::`-":;' .,";, .. •'- i " AUTOONLY=EA ACCIDENT$,---- --•---_-_. - —EA ACC` 'OTHER THAN AUTO - - AGG C EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE HDEDUCTIBLE X RETENTION $ 10,000 UMB537377204 05/01/_2009 07/01/2010 EACH OCCURRENCE $' 1 000 Q00 AGGREGATE $ 1 000, 000 $ $ $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below 4015370 07/01/2009 07/01/2010 _ X I WC STATUSF -I OTH- 1 ER E.L. EACH ACCIDENT $ lOO, OOO E.L. DISEASE - EA EMPLOYEE _lOO,, QOO E.L. DISEASE - POLICY LIMIT _ $ 500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ertificate Holder as Additional Insured as required by written contract per policy form. City of Fort Collins Purchasing Department Attn: James O'Neil P 0 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 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Shelly Sawyer/SHELLY� ACORD 25 (2001/08) FAX: (970)224-6134 ©ACORD CORPORATION 1988