Loading...
HomeMy WebLinkAboutLIBERTY COMMON SCHOOL - INSURANCE CERTIFICATERb® CERTIFICATE OF LIABILITY INSURANCE OP ID ii DATE(MMIDDiri 06 15 11 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 NAME: PHONE AIC, No, Esq: (A/C Ni Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 Fort Collins CO 80525 Phone:970-482-7747 Fax:970-484-4165 A DRESS: -CUSTOMER CUSTOMER 10 p: LIBER-B INSURER(S) AFFORDING COVERAGE I # INSURED INSURER A: TWIN CITY FIRE INS CO 29459 Liberty Common School, LCS Bµllding Corp. Tim Ricketts Fort Collins CO 8Dr. Sharp Point 05 Fort INSURER B: HARTFORD FIRE INSURANCE CO 19682 INSURER C: Hartford Casualty Ins Co 29424 a INSURERD: Plnncol Assurance 41190 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. NOTMTHSTANDING 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. LTR TYPE OF INSURANCE NSRLI WVDI POLICY NUMBER (MI DDIYYYY) (MMIDD/YYYY) I LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE N OCCUR X Educators Legal X 34UUNRA2958 07/01/11 07/01/12 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence)$300,000 MED I(Any one person) $ 10,000 PERSONAL S ADV INJURY $1,000,000 $10, 000 ded GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F7 PRO LOC JECT PRODUCTS - COMP/OP AGG $2,000,000 $ B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS 34UUNRA2958 07/01/11 07/01/12 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTYDAMAGE (Per accident) $ X $ $ * UMBRELLA LIAR EXCESS LIAR X OCCUR AI CLMS-MADE 34MURA2215 07/01/11 07/01/12 EACH OCCURRENCE IS10,000,000 AGGREGATE $ 10, 000, 000 DEDUCTIBLE RETENTION S 10,.000 X Is D WORKERS COMPENSATION I AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNEWEXECUTIVEOFFICERRAE� (Mandatoryin ER E%CLUOED7 (Mandatory in NH) u If yes. descrioe under DESCRIPTION OF OPERATIONS Below NIA I 4046263 07/01/11 I 07/01/12 X - - TORY LIMITS ER EL EACH ACCIDENT $ SOOOOO IDISEASE- EA EMPLOYEE $SOOOOO E.L. DISEASE - POLICY LIMIT 8 500000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, if more space is required) The City of Fort Collins is included as an additional insured if required by written contract. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Risk Management P.O. Box 580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITYFOR I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2009/09) ©1988-2009 The ACORD name and logo are registered marks of ACORD reserved