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Home My WebLink AboutTIMOTHY M KEOHANE - INSURANCE CERTIFICATE0Erie Insurance 100 Erie Ins. PI. - Erie, PA 16530 NAME AND NUMBER OF AGENCY KELLY FAMILY INSURANCE AGY INC 196 S. MAIN STREET NAMED TIMOTHY M KEOHANE + PO BOX 662 NAPLES NY 14512-0662 CERTIFICATE OF INSURANCE - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY - CERTIFICATE HOLDER COPY NN1037 NAME AND 585-374-9320 01/18/2012 CERTIFICATE HOLDER CITY OF FORT COLLINS 117 N MASON ST FORT COLLINGS CO 80524- This is to certify that policies, as indicated by Policy Number below, are in force for the Named Insured at the time that the certificate is being issued. GENERAL LIABILITY Q267220068 02/22/2012 02/22/2013 COMMERCIAL GENERAL LIABILITY OCCURRENCE FORM GEN'L AGGREGATE LIMIT APPLIES PER: POLICY WORKERS COMPENSATION Q867200103 02/22/2012 02/22/2013 EACH OCCURRENCE S 300000 FIRE DAMAGE (Any one premises) $ 300000 MED EXP (Any one person) $ 5000 PERSONAL &ADV INJURY $ 300000 GENERAL AGGREGATE IS 600000 'RODUCTS-COMP(OPAGG$ 600000 BODILY INJURY AND $ PROPERTY DAMAGE COMBINED EACH OCCURRENCE AGGREGATE STATUTORY AND BODILY ACCIDENT $ 100000 EACH ACCIDENT EMPLOYERS LIABILITY INJURY DISEASE $ POLICY LIMIT BY DISEASE $ 100000 500000 EACH EMPLOYEE DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS L,AINI.CLLA I WIN: JMUULU AINT Ur I nt AUUVt UtbL HItlEU ruuUlES eft GANctLLtU BEEURE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 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). - THIS CERTIFICATE IS ISSUED FOR INFORMATION PURPOSES ONLY AND CONFERS NO RIGHTS ON THE CERTIFICATE HOLDER. IT DOES NOT AFFIRMATIVELY OR NEGATIVELY LIST, AMEND, EXTEND OR OTHERWISE ALTER THE TERMS, EXCLUSIONS AND CONDITIONS OF INSURANCE COVERAGE CONTAINED IN THE POLICY(IES) INDICATED ABOVE. THE TERMS AND CONDITIONS OF THE POLICY(IES) GOVERN THE INSURANCE COVERAGE AS APPLIED TO ANY GIVEN SITUATION. LIMITS SHOWN MAY HAVE BEEN REDUCED BY CLAIMS PAID. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED ERIE INSURANCE SEE REVERSE SIDE OF-1568 08111 CIF AUTHORIZED REPRESENTATIVE