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HomeMy WebLinkAboutFOOTHILLS GATEWAY INC - INSURANCE CERTIFICATE (2)FOOGA Client#: 37379 ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDmYY) 6/2912012 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 endomement(s). PRODUCER Flood & Peterson Ins., Inc. P. O. Box 578 Greeley, CO 80632 970356-0123 CONTACT NAME: Kelly Beauvais HONE 970 266-7721 970 506-6845 PA/C No Ext: Alq No: EMAIL Kelley.Beauvais floodand eterson.com ADDRESS: @ P CUSTOMER ID#: INSURER(S) AFFORDING COVERAGE NAIC# INSURED Foothills Gateway, Inc. 301 West Skyway Drive Fort Collins, CO 80525 INSURER A: Philadelphia Insurance COmpame INSURERS, Pinnacol Assurance Travelers Insurance Company INSURERC: P Y INSURER D: INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS 15 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 rypE OF INSURANCE DOL UBR POLICY NUMBER MMIDDIYYYY MMIDDNYYV LIMITS • GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR PHPK885996 7/01/2012 07101/2013 EACH OCCURRENCE $1000000 PREMISES Eaoccunence $100000 MED EXP(Any one person) $10,000 PERSONAL B ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000,000 GENL AGGREGATE LIMIT APPLIES PER: 17 POLICY PRO-JECT F-1 LOC PRODUCTS - COMPIOP AGG s3,000,000 I$ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS PHPK885996 7/01/2012 07/01/2013 COMBINED SINGLE LIMIT (Ea accdent) $1,000,000 X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accdent) $ X X $ $ A �UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE PHUB387364 7/01/2012 07/01/201 EACH OCCURRENCE $2,000,000 AGGREGATE s2,000,000 RETENTION 10000 $ HDEDUCTIBLE X $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y OFFICERIMEANY IM ERE%CLUDED?ECUrIVE[ NJ (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA 703552 7/01/2012 07/01/2013 X I WCSTATU- I OTH- EL EACH ACCIDENT $500,000 E. L. DISEASE - EA EMPLOYEE s500,000 E.L. DISEASE -POLICY LIMIT s500 000 C IProfessional Liabili 105635660 7/01/2012 07/01/201 3,000,000 Aggregate 1,000,000 Occurrence DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mom space Is required) RE: Flying Pig Charity Run/Walk Fundraiser, April 22, 2012 Certificate holder, its officers, employees and agents are named as additional insured. City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO Box 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD flS712764IM712764 S7f: