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HomeMy WebLinkAbout233452 FAMILY CENTER LA FAMILIA KIMBERLY SPENCER - INSURANCE CERTIFICATEOP ID: SM CERTIFICATE OF LIABILITY INSURANCE . 09114 DATDIYYYY) osn an 1 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. ir ---"---""'"-'" `�' IMPORTANT:;, If the certificate holder is an ADDITIONAL'. INSURED, the policy(ies)' must be endorsed., If SUBROGATION CIS �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'� ---certificateholder in lieu of suclrendon;ement Cal. ----•-- _ -_ -'-- -'-"-• "' -"'-"""-""-'"" """ _ :"`=�--""--"'_�__.,_.....___. PRODUCER L_-' 303-799-0110 Cherry Creak Ine`Agency"Inc: Suite 500 303-799-0156 5660 Greenwood Plaza Blvd. ------- - -' I GreenwoodkInsurance A 11 Cherry Creek Insurance Agcy CONT NAMEgCT Stephanie Malia F, AleNe Ea1,720-212-2028, .FAX 303-799-0156 %., 5r _. E-MAIL - - - -- -- ADDRESs: stephanie.malia cher creekins.cotb PRODUCER -. - .- - - -- - — --------- CUSTOMER to a: FAMI-03:; •,r INSURERS AFFORDING COVERAGE NAIC p INSURED The Family Center La Familia Kimberly Spencer 309 Hickory #5 Fort Collins, CO 80524 INSURER A: Pinnacol Assurance 41190 INSURER B: Philadelphia Insurance Company 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. INSR TR TYPE OF INSURANCE POLICY NUMBER EFF MMPOLICY IDDIYYYY POLICY E XP MM/DD/YYY' LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 PREMISES Ea occunence $ '100,00 B X COMMERCIAL GENERAL LIABILITY X PHPK718224 06I02111 06I02112 CLAIMS -MADE OCCUR - MED EXP (Any one parson) $ 5,00 X' Abuse/Molestation r---'--—`-"PERSONAL BAOV INJURY $ — 1r000,O0 :.r GENERALFGGREGATE ` - $ ^ 3,000,00 .nt "'GEN'LJAGGREGATE _:�..: 1.. r `..V , ., A u'. ,._ •- a,._._ tC _ .____._.�:c+, f ° `,. 1,9 ,�__..____ .� r L _._. --.-.._Abuse--` LIMIT APPLIES PER: 0.. _ PRO- -- Pucv --'Loc-.--.:.. PRODUCTS COMP/OP AGG $ 3,000,00 --'—'$'_._.._..__7;000;00 B , __-__.. AUTOMOBILE LIABILITY rr-1 a r -,l .. ANY AUTO a fJ ._..... .. .-,_.___..._.._...__ ,;. --...-... JI ' Y.. ,.. r- - _x :,, ,•„'G ..:-.. J. _ ..� PHPK718224 ' '- "' __..__. ... .._ a: - +: ••• ...?., 06102/14 - :m _. .. I O6/02H2f .. I COMBINED SINGLE LIMIT05 - (Ea aaidenq. .:- ., ' i-�100000 , ;:. _ ' - BODILY INJURY (Per person) $ .-..•.. _.._ - + - ALLOWNED'AUTOS �.. .. �� _ " Xi + - BODILY INJURY (Per accident) $ SCHEDULED AUTOS • - HIRED AUTOS PROPERTY DAMAGE (Per accitlenU $ ' -X X $ NON-OWNEDAUTOS -- UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DEDUCTIBLE $ cNTIPN ¢ WORKERS COMPENSATION WC STATU- OTH- A A AND EMPLOYERS' LBILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NH) NIA 4031427 08101/11 08/01/12 E E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE -EA EMPLOYEE $ 100,000 If yes, desnibe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 600,000 B Property Section PHPK718224 06/02/11 06/02/12 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks Schedule, If more space Is required) Per written contract or written agreement, the Certificate holder is listed as Additional Insured under the General Liability where there interests may appear with respects to operations of the Named Insured. City of Fort Collins 300 Laporte Ave Fort Collins, CO 80521-2719 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/ REPR,ES\�ENTAT�IVEA /'n ,�— © 1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD