HomeMy WebLinkAboutARCHDIOCESE OF DENVER - INSURANCE CERTIFICATE (4)ACORO
® CERTIFICATE OF LIABILITY INSURANCE
o6 ATE (..IDD u
D06/21 IDDI11
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: H 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 1-303-773-9999
Arthur J. Gallagher Risk Management Services, Inc.
CONTACT
NAME:
PHONE FAX
JAIC,No,€_ A/C No:
E-MAIL
ADDRESS:
6399 S. Fiddlers Green Cir
Suite 200
Greenwood Village, CO 80111
INSURERS AFFORDING COVERAGE
NAIC X
INSURER A: PINNACOL ASSUR
41190
INSURED
INSURER B :
Archdiocese of Denver
INSURER C :
INSURER D:
1300 S. Steele Street
INSURER E:
Denver, CO 80210-2599
NSURERF:
r:nVFRAr:FC r:FRTIFIr:ATF NIIMRFR• 21864730 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
LTR
TYPE OF INSURANCE
ADDL
SUBMwvo
POLICY NUMBER
MMM�YEFF
POLMWDICDYEXP
LIMITS
GENERAL UABIUTY
EACH OCCURRENCE
$
COMMERCIAL GENERAL LIABILITY
AMA
PREMISES Ea ocwrre.
S
CLAIMS -MADE F-IOCCUR
MED EXP(Any one person)
$
PERSONAL B ADV INJURY
$
GENERAL AGGREGATE
$
GEN'L AGGREGATE
LIMIT APPLIES PER:
PRODUCTS - COMPIOPAGG
$
$
POLICY
PRO- LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
BODILY INJURY (Per person)
$
ANY AUTO
BODILY INJURY (Per accident)
S
ALL OWNED SCHEDULED
AUTOS AUTOS
PROPERTYDAMAGE
Peru dent
$
NON -OWNED
HIRED AUTOS AUTOS
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTIONS
$
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETOWPARTNER/EXECUTIVE YIN
4083045
07/01/1
07/01/12
X WCSTATU- OTH-
DRY LIMITS ER
E.L. EACH ACCIDENT
$ 1,000,000
OFFICERIMEMBER EXCLUDED?
NIA
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
(Mandatory In NH)
If yce, tlescdbe antler
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1, 000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aeach ACORD 101, Additional Remarks Schedule, N more apace is required)
RE: CCS North to perform Utility Assistance Program administration for the City of Fort Collins, Colorado from
January 01, 2010 to December 31, 2010.
of Fort Collins
Director of Purchasing and Risk Management
P O Box 580
Collins, CO 80522
USA
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 (2010105) The ACORD name and logo are registered marks of ACORD
mramden
21864730
3:4
Arthur J. Gallagher Risk Management Services, Inc.
6399 S. Fiddlers Green Cir E B IX B P O
Suite 200
Greenwood Village, CO 80111
USA
City of Fort Collins
C/O Director of Purchasing and Risk Management
P O Box 580
Fort Collins, CO 80522
USA 7:N5:360
III III IIIIIIIIII IIIII III IIIIIIIIIII III IIIII III III 1111111111 III
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