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HomeMy WebLinkAboutFOOTHILLS GATEWAY INC - INSURANCE CERTIFICATEClient#: 37379
FOOGA
ACORD,. CERTIFICATE OF LIABILITY INSURANCE
ATE(MM/DD YYYY)
DATE"""'
F
06/17/2011
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 ins., Inc.
P. O. Box 578
Greeley, CO 80632
970 356-0123
CONTACT NAME: Kelly Beauvais
PHONE 970 266-7121 970 506-6846
Ezt : A/0, No
ADOREss: Kelly.Beauvais@fpinsurance.com
im,—e.?Ielly.Beauvais@fpinsurance.com
CUSTOMER ID#:
INSURERISI AFFORDING COVERAGE
NAIL 0
INSURED
Foothills Gateway, Inc.
301 West Skyway Drive
Fort Collins, CO 80525
INSURER A: Philadelphia Insurance Companle
INSURER BPinnacol Assurance
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
POLICY NUMBER
(MMOD/YYYY
MM/DD/VYYY
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE I OCCUR
PHPK735291
7/01/2011
07/01/2012
EACHOCCURRENCE
$1000000
PREMISES Ea occurrence
$100000
MED EXP (Any one person)
$10,000
PERSONAL& ADV INJURY
$1,000,000
GENERAL AGGREGATE
$3,000,000
GEN'L AGGREGATE
POLICY
LIMIT APPLIES PER:
Ro- LOG
PECT
PRODUCTS - COMP/OP AGG
s3,000,000
S
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
PHPK735291
7/01/2011
07/01/2012
COa MBINED)INGLE UMU
S1,000,000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident)
$
1XX
PROPERTY DAMAGE
(Per accident)$
S
$
A
X
UMBRELLA LAB
EXCESS LIAB
OCCUR
CV.IMS.MADE
PHUB348927
7/01/2011
07/01/201
EACH OCCURRENCE
s2000000
AGGREGATE
s2,000,000
DEDUCTIBLE
RETENTION 10000
$
X
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORrPARTNER/EXECURVE —
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
It yes, describe under
DE SCRIPTION OF OPERATIONS below
WA
703552
7/01/2011
07/01/201
X YJc srnru OTH-
E.L. EACH ACCIDENT
$500 000
E.L. DISEASE - EA EMPLOYEE
$500,000
E. L. DISEASE -POLICY LIMIT
$500000
A
Professional
Liabilit
PHPK735291
7/01/2011
07/01/201
$3,000,000 Aggregate
$1 000 000 Occurrence
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD lot, Additional Remarks Schedule, it more space is required)
RE: Flying Pig Charity Run/Walk Fundraiser, April 10, 2011
Certificate holder, its officers, employees and agents are named as
additional insured.
City of Fort Collins
PO 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
ACORD 25 (2009/09) 1 of 1
#S622529/M622523
01988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
KLB