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Home My WebLink About315931 BIG THOMPSON WATERSHED FORUM - INSURANCE CERTIFICATE (2)'4Lc.°RO® CERTIFICATE OF LIABILITY INSURANCE TE 11_07f-toil THIS CERTIFICATEIS 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 SUBROGATIONIS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statementon this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: PAYCHEX INSURANCE AGENCY INC PHONE E.n: FAX (888) 443-6112 210705 P:O - F:(888)443-6112 _WC. PO BOX 33015 PROD UCE SAN ANTONIO TX 78265 CUSTOMER ID N: INSURER(S) AFFORDING COVERAGE NAIL # INSURED INSURER A: Twin City Fire Ins CO INSURER B: BIG THOMPSON WATERSHED FORUM 800 S TAFT AVE INSURER C: LOVELAND CO 80537 INSURER D INSURER E INSURER F COVFRAGFS 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 LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DDlYYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-I OCCUR EACH OCCURRENCE I $ PREMISES (Ea occurrence) $ MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ I GEWL AGGREGATE LIMIT APPLIES PER: _I POLICY III JECT I I LOC PRODUCTS - COMPiOP AGG 1 $ $ I AUTOMOBILE LIABILITY ANY AUTO OWNED AUTOS SCHEDULED AUTOS I HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ JALL J BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ s $ UMBRELLA LIAB I_I OCCUR EXCESS LIAB CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ _ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEIIY / Nu I doryinNHREXCLUDED7 (Mana If yes, describe under DESCRIPTION OF OPERATIONS below NIA 76 WEG PE5980 01/01/2012 01/01/2013 X - TWC STATUOTH- ORY LIMITS ER E.L. EACH ACCIDENT $ 100, 000 E.L. DISEASE EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Those usual to the Insured's Operations. CFRTIFICATF HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The City Of Fort Collins BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE Fort Collins WTP DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEg R PRESENTATIVE a-z- 4316 LAPORTE AVE FORT COLLINS, CO 80521 1988.2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD