HomeMy WebLinkAboutDISCOVERY CENTER SCIENCE - INSURANCE CERTIFICATEJ W CERTIFICATE OF LIABILITY INSURANCE OF ID DA
DATE(MM/DD/YYYY)
06 04 12
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
NAME:
A/G, No, Ezt:
Brown & Brown Inc
4532 Boardwalk Dr, Suite 200
ADNESS:
Fort Collins CO 80525
PRGDOCER
CUSTOMER ID p: DISCO-1
Phone:970-482-7747 Fax:970-484-4165
INSURER(S) AFFORDING COVERAGE
NAICN
INSURED
D'scovery Center Science
C 0 Annette Geiselman
INSURER A: valley Forge insurance company
20508
INSURER B:
INSURER C:
4 8 Mason Ct
Ft Collins CO 80524
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 REOUIREMENT, 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.
INS
LTR
TYPE OF INSURANCE
ADD
INSR
SUB
WVD
POLICY NUMBER
PMDD1'EFFT
(MMIDD/YYYY)
POLICYEXP
(MM/DDNYYY)
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE T OCCUR
X
B4018247136
05/18/12
05/18/13
EACH OCCURRENCE
$ 1, )001000
DAAGSEKoNI0ncePc re)
S 300, OOO
MED EXP (Any one person)
$ 10,000
PERSONAL B ADV INJURY
$1,000,000
GENERAL AGGREGATE
S 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
POLICY PRO LOC
PRODUCTS - COMP/OP AGG
$2,000,000
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OW NED 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
$
AGGREGATE
is
DEDUCTIBLE
RETENTION $
$
WORKERS COMPENSATION
ANDEMPLOYERS'LIABILITY YIN
ANY PROPRIETOR/PARTNERIEXECUTIVEf—
OFFICERIMEMBER EXCLUDED? uu
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N I A
U- -
TORY LIMIT $ ER
E.L. EACH ACCIDENT
$
E.L. DISEASE- EA EMPLOYEE
$
E.L. DISEASE -POLICY LIMIT 1
$
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101 Additional Remarks Schedule, if more space Is requlred)
City of Fort Collins is included as Additional Insured with respects to
General Liability per form SB-146932-E
lmurray@fcgov.com
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITYFIO I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
215 N. Mason St.
Fort Collins CO 80521
All rights reserved.
ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD