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ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MWDD/YYYY)
03/02/2011
THIS CERTIFICATE IS 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 SUBROGATION IS 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
Flood &Peterson Ins., Inc.
P. O. Box 578
Greeley, CO 80632
970 356-0123
CONTACT
Kelly Beauvais
ONE 970 2667121 FAX
9P70 506-6846
No Ext : (A/C, No
/C -
E-MAIL Kelly. Beauvais@fpinsurance.com
PRODUCER
CUSTOMER ID B:
INSURER(S) AFFORDING COVERAGE
NAIC It
INSURED
Platte River Power Authority
2000 E. Horsetooth Road
INSURER A: The Hartford Insurance
INSURER B:
Fort Collins, CO 80525
INSURER C :
INSURER D
INSURER E:
INSURER F:
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.
INSR
LTIL
TYPE OF INSURANCE
D L
NSR
U R
NVD
POLICY NUMBER
POLICY EFF
MM/DD/YYYV
POLICY EXP
MWDD/YYYY
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
$
DAMA RENTED
PREMISES Ea occurrence
$
MED EXP (Any one person)
$
PERSONAL B ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO LOC
PRODUCTS - COMP/OP AGG
$
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
34UENEL8815
2/01/2011
02/01/2012
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY (Per person)
S
BODILY INJURY (Per accident)
S
PROPERTY DAMAGE
(Per accident)
$
X
X
$
$
UMBRELLA LIAR
EXCESS LAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
S
DEDUCTIBLE
RETENTION $
S
is
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/ N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
I WC STATU- OTH-
E.L. EACH ACCIDENT
S
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space is required)
City of Fort Collins
PO Box 580
Ft Collins , CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
01988-2009 ACORD CORPORATION. All rights reserved.
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