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Home My WebLink About315931 BIG THOMPSON WATERSHED FORUM - INSURANCE CERTIFICATE� A� ® CERTIFICATE OF LIABILITY INSURANCE F DATE 11-09-201)0 THIS CERTIFICATEIS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER PAYCHEX INSURANCE AGENCY INC 210705 P:()- F:(888)443-6112 CON C NAME: PHONE Eo Ext): a/c,NoJ: (888) 443-6112 PO BOX 33015 ADDRESS: PRODUCER SAN ANTON I O TX 78265 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE I NAIC /t INSURED INSURER A : Twin City Fire Ins Co INSURER B BIG THOMPSON WATERSHED FORUM 2890 MONROE AVE INSURER C LOVELAND CO 80538 INSURER D INSURER E INSURER F : I COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DDIYYYY) POLICY EX P (MM/DD/YYYY) I LIMITS GENERAL LIABILITY EACH OCCURRENCE I $ COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) I $ CLAIMS -MADE U OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY a PRO L LOC JECT $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ $ NON -OWNED AUTOS $ UMBRELLA LIAB U OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ $ RETENTION $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS' LIABILITY Y/ N TORY LIMITS ER E.L. EACH ACCIDENT $ 100, 000 ANY PROPRIETOR/PARTNER/EXECUTIVE A 'Mandatory inNHREXCLUDED? u N/ A 76 WEG PE5980 01/01/2011 01/01/2012 E.L. DISEASE - EA EMPLOYE $ 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The City Of Fort Collins BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Fort Collins WTP DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 4316 LAPORTE AVE FORT COLLINS, CO 80521 AUTHORIZE R PRESENTATIVE7 0 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD