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HomeMy WebLinkAboutLARIMER HUMANE SOCIETY - INSURANCE CERTIFICATE (7)ACORDM CERTIFICATE OF LIABILITY INSURANCE o6/30/2 o' 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 -.,I, NAIC # INSURED Larimer Humane Society INSURERA: Great American_Ins6ra '6 Co._ 5137­-South College Avenue INSURERB: Great American IAssurance Co. Fort Collins, CO 80525 i INSURERc: Great American Alliance Ins_. -Co!._ 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. INSR DD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION 07/01/2011 LIMITS EACH OCCURRENCE $ 1, 000., OOO is GENERAL LIABILITY PAC537377005 07/01/2010 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE M OCCUR DAMAGE TO RENTED 100.0001 MED EXP (Any one person) $ 10,000 A PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY D PROECT LOC J AUTOMOBILE LIABILITY ANY AUTO CAP537377105 07/01/2010 07/01/2011 COMBINEDSINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) - • - -•- $ — -- g-- ALL OWNED AUTOS SCHEDULEDAUTOS :.-y .�,......, NON -OWNED AUTOS - - ' s - - - ... .. ... ... XHIREDAUTOS" - .. BODILY INJURY (Peraccident).r-S : ' - - - --- - - -- $ X - PROPERTY •DA - DAMAGE' (Per accdent) - - $ • _- - — -- - - - - -- - - - - — GARAGE LIABILITY _ AUTO ONLY - EA ACCIDENT $ ANY AUTO ' OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY X OCCUR CLAIMS MADE UMB537377204 07/01/2010 07/01/2011 EACH OCCURRENCE $ 1,000,000 _ AGGREGATE $ 1,000,000 C $ DEDUCTIBLE $ X RETENTION $ 10,00 $ WORKERS COMPENSATION AND 4015370 07/01/2010 07/01/2011 X I WCSTATU- JOTH- EMPLOYERS' LIABILITY - E.L. EACH ACCIDENT $ - 1rIO, 000 D ANV PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - FA EMPLOYEE $ 100,000 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 J AI.UKU LD (LUUI/US) r/AA- 1,7IVJ444-0134 ©ACORD CORPORATION 1988