HomeMy WebLinkAbout174626 FORT COLLINS HABITAT FOR HUMANITY - INSURANCE CERTIFICATE (3)ACORO®
I*�-
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDOr/YYV)
82,21I2D,2
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
INSURERS(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: IftFie 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
Acr '-
Lockton Risk Services
P.O. Box 410679
HONE
AIC No.E.q: 888-553-9002
AX
AIC, No):
E-MAIL
ADDRESS'
Kansas City, MO 64141-0679
INSURER(S) AFFORDING COVERAGE
NAIC
.'I
NSURER-A: Federal Insurance Co.
20281
INSURED
NSURER-B:
Fort Collins Habitat for Humanity
NSURER-C:
4001 S Taft Hill Rd,
Fort Collins, CO 80526-2948
NSURERD:
NSURERIE:
INSURER-F:
�d�Pl �7_[eTY.��T7:iify[�7_\i��t1IITi17�t N�76iN7���01111:7�[
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.
IN
SR
T
R
TYPE OF INSURANCE
ADDL
INSR
SUB
R
VD
POLICY NUMBER
bOLICY Err
MMIDDIYYYY)
OLICY EXP
MMIDDIYYYY)
LIMITS
A
GENERAL LIABILITY
OMMERCIALGENERAL LIABILITY
ii-AIMS MADE X OCCUR
GL1064502-12
- -
-
04/01/2012
-
04/01/2013
'
-
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES (Ea occurrence
$1,000,000
MED EXP (Any one erson
$'-I� 0
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
EN'L AGGREGATE' LIMIT APPLIES PER.
X LICY
PRODUCTS-COMP/OP AGG
$2,000,000
$
AUTOMOBILE LIABILITY
NY AUTO
LL OWNED SCHEDULED
UTOS AUTOS
NON -OWNED
IRED AUTOS AUTOS
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY Per Person
$
BODILY INJURY Per accident
$
PROPERTY DAMAGE
Per accdent
$
MBRELLA LIAR
XCESS LIAB
OCCUR
CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
EO I I RETENTION S
WORKERS COMPENSATION
ND EMPLOYERS' LIABILITY
NY PROPRIETOR/PARTNER/EXECUTIVE YIN
%
C STATU-
ORY LIMITS
OTH-
R
FFICEFUMEMBER EXCLUDEDP
E. L. EACH ACCIDENT
$
MANDATORY IN NH)
f yeb, describe under
E. L. DISEASE - EA EMPLOYEE
$
DESCRIPTION OF OPERATIONS below
E. L. DISEASE -POLICY LIMIT
$
Proof of Coverage
City of Fort Collins
P.O. Box 580,
Fort Collins, CO 80522
CANCELLAI IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS
ACORD 25 (2010/05) The ACORD name and logo are
1064502