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174626 FORT COLLINS HABITAT FOR HUMANITY - INSURANCE CERTIFICATE (2)
ACORD.M CERTIFICATE OF LIABILITY INSURANCE osjozjzoii PRODUCER Lockton Risk Services THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 410679 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Kansas City, MO 64012 INSURERS AFFORDING COVERAGE - NAIC # INSURED Fort Collins Habitat for Humanity 4001 S Taft Hill Rd, INSURER A'. Federal Insurance Co 20281 INSURER B'. INSURER C: Fort Collins, CO 80526-2948 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 POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL LTR INSRo TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE NMIODIVV DATE MMIDDIYY LIMITS A GENERAL LIABILITY GL1064502-11 GN01/2011 01/01/2012 EACH OCCURRENCE 1.000,000 DAMAGTO RENTED PREMISES Eaocwoence 1,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE I X I OCCUR MED EXP (Any oneperson) 0 PERSONAL & ADV INJURY 1,000,000 GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OP GEN'L AGGREGATE LIMIT APPLIES PER. AGG 2,000,000 X PRO- POLICY 11 JECT 11 LOG AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO Each accident $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS Perperson) S HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) $ PROPERTY DAMAGE Per accident $ AUTO ONLY - EA GARAGE LIABILITY ACCIDENT ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY AGG EXCESSIUMBRELLA LIABILITY OCCUR O CLAIMS MADE EACH OCCURRENCE $ I AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY wC STnTU-iOBy un+RS OTwER E.L.EACHACCIOENT $ ANY PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below EL. EACH ACCIDENT $ E.L. EACH ACCIDENT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Proof of Coverage CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER _ CANCELLATION 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 DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE City of Fort Collins P.O. Box 580, Fort Collins, CO 80522 ACORD 25 (2001/08) ©ACORD CORPORATION 1988 1064502 IIJtlll:ir_1Zk1 If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.