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HomeMy WebLinkAbout113874 FOOD BANK FOR LARIMER COUNTY - INSURANCE CERTIFICATE (4)Client#: 47247
FOOBAI
ACORD. CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
O6/17/2011
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 Ina., Inc.
P. O. Box 578
NAME:
PHONE 970 356-0123
ac no Exl : A/C, No): 9703301867
Greeley, CO 80632
970 356-0123
ADDRESS:
CUSTOMER ID N:
INSURER(S) AFFORDING COVERAGE
NAIC p
INSURED
Food Bank for Larimer County
1301 Blue Spruce Drive
Fort Collins, CO 80524
INSURER A: Philadelphia Insurance Companje
INSURER B
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.
TYPE OF INSURANCE
dL
POUCY NUMBER
MOM%DDNYYYY
POLICY /YYYY
LIMITs
A
GENERAL LIABILITY
X COMMERCIAL GENERALUABWTY
CLAIMS MADE FxIOCCUR
PHPK731268
7/01/2011
07/01/201
EACH OCCURRENCE
$1000000
PREMISES Eaoccuoenoe
S1000O0
MED EXP (Any one person)
$5,000
PERSONAL &ADV INJURY
$1,000,000
GENERAL AGGREGATE
32,000,000
GENL AGGREGATE
POUCV
LIMIT APPLIES PER:
PRO- LOC
IFCTAUTOMOBILE
PRODUCTS - COMP/OP AGG
s2,000,000
$
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE UMIT
(Ea accident)
$
BODILY INJURY (Per person)
3
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
ac
(Per cidenQ
$
$
A
X
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
PHUB347920
7/01/2011
07/01/201
EACH OCCURRENCE
$4000000
AGGREGATE
s4,000,000
DEDUCTIBLE
RETENTION 10000
$
X
$
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY YIN
ANY PROPRIETOWPARTNER/EXECUTIVEâť‘
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH)
ifyes, describe under
DESCRIPTION OF OPERATIONS below
NIA
WC STATU-
YLIMITS OTH-
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
$
A
A
Inland Marine
D&O
PHPK731268
PHSD629851
7/01/2011
7/01/2011
07/01/201
07/01/201
$57,750 Blanket
$2 000 000/$2 500 Ded
DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks schedule, If morespace is required)
Attn: Deputy City Clerk - Amy Jensen
(See Attached Descriptions)
City of Ft Collins
P O Box 580
Fort 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
F%OocR T' '0A'4ls6.s'j - CA i iNC.
01988.2009 ACORD CORPORATION. All rights reserved.
ACORD 25 (2009/09) 1 Of 2
#S622888/M622881
The ACORD name and logo are registered marks of ACORD
PXP