HomeMy WebLinkAboutPLATTE RIVER POWER AUTHORITY - INSURANCE CERTIFICATEClient#: 14403
PLARI
ACORDTd CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
01/30/2012
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
970356-0123
CONTACT NAME: Kelly Beauvais
PHONE No 970 266-7121 970 506-6846
A/C Eh : A/L, No
- A L K
ADDRESSell B
: y eauvaisefloodandpeterson.com
PRODUCER
CUSTOMER ID C
INSURER(S) AFFORDING COVERAGE
NAIC0
INSURED
INSURER A: The Hartford Insurance
Platte River Power Authority
2000 E. Horsetooth Road
INSURER B
Fort Collins, CO 80525
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
LTR
rypE OF
%DDL3UBR
N R
WO
POLICY NUMBER
POLICY EFF
MM/DD/YYYY
POLICY EXP
MWDDNYYY
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
8
PREMISES Ee occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
S
GENERAL AGGREGATE
$
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRET LOC
PRODUCTS - COMP/OP AGG
S
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS .
NON -OWNED AUTOS
34UENEL8815
2101/2012
02101/2012
LIMIT
CO accident)
IS(Ea1,000,000
X
BODILY INJURY (Per person)
IS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
(Per accidenI)
$
X
X
$
S
UMBRELLA LIAB
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
Is
DEDUCTIBLE
RETENTION 5
$
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETORIPARTNER/EXECUTIVEâť‘
OFF(CER/MEMBER EXCLUDED?
(Mandatory in NH)
It yes, descdDe under
DESCRIPTION OF OPERATIONS below
WA
WC STATU- OTH-
TngyU
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT
S
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (AfMch ACORD 101, Additional Remarks Schedule, H more sides Is required)
City of Fort Collins
PO Box 580
Ft 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 (2009109) 1 of 1
#S671523/M671516
m 1988-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
KLB