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HomeMy WebLinkAboutLARIMER HUMANE SOCIETY - INSURANCE CERTIFICATE (6)DATE ACORDM CERTIFICATE OF LIABILITY INSURANCE 1 04/29/2 0' PRODUCER (303) 776-5122 FAX (303) 776-5495 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION First Mai nStreet Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 512 4th Avenue 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.Insur_ance-Co.'-._.�.. _. 5137 South College Avenue INSURERB: Great.American_As_surance.;Co." Fort Collins, CO 80525 INSURERc: Great American'Alli'ance.Ins Co.... 5 INSURERD: Pinnacol Assurance,-"'-.'..--,,.-.--. _.__--..._-.. 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. INSRADD' TYPE OF INSURANCE . POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A GENERAL LIABILITY - X I COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR PAC537377005 05/01/2009 - 07/01/2010 - EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 MED EXP (Any one person) $ .. 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROECT LOC J PRODUCTS - COMP/OP AGG $ 2,000,000 • . - AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOSBODILY SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CAP537377105 05/01/2009 ^+ 4 07/01/2010 - - _ - • -, COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X - - (Per person) - - X BODILY INJURY (Per accident) $ X PROPERTY DAMAGE - (Per accident) __. ...._.._ .a. $ _ GARAGE LIABILITY ._ .. - ', ANY AUTO _ _ _ _- - 4 .f ..... _ . _.' '_ - .., - - : -. .. _._.�._. .. - - •- - AUTQONLYEEAACCIDENT,_. .. .$.;._...__.. . _._ ..... .. .. OTHER THAN EA ACC AUTO ONLY: AGG $ C EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE HDEDUCTIBLE X RETENTION $ 10 , 00 UMB537377204 05/01/2009 07/01/2010 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1', 000, 000 $ $ $ _.D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY "ANY' PROPRIETOWPARTt4EPiEXECUTi\,'E ' OFFICER/MEMBER EXCLUDED? If yes, describe under - SPECIAL PROVISIONS below 4015370 07/01/2009 _ 07/01/2010 X I WC STATU- OTH- E.L^EACH ACCIDENT__ $ 100, 000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT 1 $ 500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS City of Fort Collins as Additional Insured as required by written contract per policy form. vent: Fire Hydrant Five: 5K Run & 3K Pledge Walk, May 9, 2009. City of Fort Collins Attn: Risk Management P 0 Box 580 Fort Collins, CO 80522-0580 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)221-6296 ©ACORD CORPORATION 1988