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Home My WebLink AboutREALITIES FOR CHILDREN INC - INSURANCE CERTIFICATETJ�1�7 �1 "%'WrAK CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDNYYY) 05/09/2012 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 CONTACT NAME: Katie Klimek Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. N E„:970.679.7333 aDNe:866.456.4265 aCfl E-MAIL ADDRESS: katie-klimek@leavitt.com Suite 100 Loveland, CO 8OS38 PRODUCER 00007801 CUSTOMER ID k: INSURER(S) AFFORDING COVERAGE NAICN INSURED INSURER A: Philadelphia Insurance Company 023850 Realities for Children, Inc. INSURER B: 1610 S. College Ave. INSURER C: Fort Collins, CO 80525 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 12-13 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 INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDfYYYY LIMITS A GENERAL LIABILITY %( COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PHPK857223' 05/22/2012 05/22/2013 EACH OCCURRENCE $ 1,000,00 DAMAGETO RENTED PREMISES $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X 1 POLICY F PRO- ECT LOC PRODUCTS - COMPIOP AGO $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) 8 PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ RRDEDUCTIBLE ETENTION $ $ $ WORKERS COMPENSATION ANDEMPLOYERS'LIABIUTY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) (DESCRIPTION OF OPERATIONS below NIA WC STATU- I OTH- TORY LIMITS ER E. L. EA CH ACCIDENT $ EL DISEASE -EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT 8 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, AddlUonal Remarks Schedule, if more space Is requlmd) The City of Fort Collins, its officers, agents, employees, and volunteers are named as additional insured as it relates to the Realities Rally and Ride which will be held on May 26th-27th, 2012. City of Fort Collins Risk Management PO Box 580 Forst Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. REPRESENTATIVE ACORD CORPORATION. All ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD A /�/1171'1 CERTIFICATE OF LIABILITY INSURANCE F DATE(MMIDDYYYY) OS/09/2012 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 CONTACT NAME: Katie Klimek Ewing -Leavitt Insurance Agency nc°NeEzt:970.679.7333 MCNp:866.456.4265 4025 St. Cloud Dr. E-MAIL ADDRESS: katie-klimek@leavitt.com Suite 100 Loveland, CO 80538 PRODUCER 00007801 CUSTOMER ID N: INSURER(S) AFFORDING COVERAGE NAIL It INSURED INSURER A: Philadelphia Insurance Company 023850 Realities for Children, Inc. INSURER B: 1610 S. College Ave. INSURERC: Fort Collins, CO 80525 INSURER D: INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 12-13 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 OFINSURANCE ADDLSUBR INSR WVD POLICY NUMBER POLICYEFF MMIDDIYYYY POLICYEXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS-MADE O OCCUR PHPK857223! 05/22/2012 05/22/2013 EACH OCCURRENCE $ 1,00D,000 DAMAGE TO RENTED ce PREMISES Ea occurzen $ lOO, OOO MED EXP (Any one person) $ 5,000 PERSONAL If ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JEo r LOC PRODUCTS-COMPIOPAGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE I s AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/E%ECUTIVE OFFICERIMEMBER EXCLUDED? (Myandatory in NH) If s DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISFASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) ity of Fort Collins, Downtown Business Association, and Downtown Development Authority re named as additional insureds as respects general liability. his policy excludes any and all automobile liability. City of Fort Collins PO Box 580 Fort Collins, CO 80522 LARV MLLAI IVIN 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) The ACORD name and logo are registered marks of ACORD