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129790 THE FEET INC - INSURANCE CERTIFICATE (4)
From: Tort Griscavage At: Brown & Brown of Colorado FaxID: (970) 484-4165 To: David Carrey Date: 6/30/2010 03:07 PM Page: 2 of 2 ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID T DATE (MMIDDIYYYY) FEET-01 06/30/10 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 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P 0 Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Fort Collins CO 80522-2226 Phone: 970-482-7747 Fax:970-484-4165 INSURERS AFFORDING COVERAGE NAICA INSURED INSURER A: Mountain States Mutual 14648 INSURERB: AGCS Marine Insurance Co. 22837 The Feet, Inc. velocity Boys, Inc. dba: INSURERC: Pinnacol Assurance 41190 622 Sherry Dr. Fort Collins CO 80524 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 nOLICIE£. ACCnFC ASE LIMIT£ SHOWN M W HAVE BEEN nFDUCED BY R1,ID CLAIMS. LTR INSRC TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MWDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X X COMMERCIAL GENERAL LIABILITY CPP010129607 07/01/10 07/01/11 �cPREMISES(Eaocurence) $ 100,000 CLAIMS MADE :X] OCCUR MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2, 0 00 , 0 0 0 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PE4 LOC AUTOMOBILE LIABILITY A X ANY AUTO BAP010129607 07/01/10 07/01/11 COMBINED SINGLE LIMIT (Ea accident) $ 1 000 000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY. AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000 A X OCCUR CLAIMSMADE UMB010129605 07/01/10 07/01/11 AGGREGATE $ 1,000,000 $ DEDUCTIBLE $ X RETENTION $ 10 , 000 $ WORKERS COMPENSATION AND X TORY LIMITS ER C EMPLOYERS' LIABILITY ANY PROPRIETOP/PARTNEP/EXECUTIVE 3534074 07/01/10 07/01/11 E.L. EACH ACCIDENT $ 1000000 OFFICER/MEMBER EXCLUDED? E.L. DISEASE -EA EMPLOYEE $ 1000000 If yes, describe under E,L.DISEASE- POLICY LIMIT $ 1000000 SPECIAL PROVISIONS below OTHER B Trans/Motor Truck MZI98470793 02/15/10 02/15/11 Limit $100,000 Cargo I Ded $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS City of Fort Collins is included as Additional Insured with respects to General Liability. Fax #221-6707 �r G" I luiVmI G nw6mr-n GANGtLLAtION CITYDIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN Purchasing Division NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn : David Carrey IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO Box 580 Fort Collins CO 80522-0580 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ITyler Allen ACORD 25 (2001/08) ©ACORD CORPORATION 1999