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HomeMy WebLinkAboutFRONT RANGE INSTITUTE OF SAFETY DBA MARK ROSOFF - INSURANCE CERTIFICATEFRINS-1 OP ID: DA CERTIFICATE OF LIABILITY INSURANCE DAT/24 12D/YYYV) 1/24112 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 Phone: 970-482-7747 CONTACT NAME: _ Brown $ Brown Inc Fax: 970-0644165 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 House Account PHONE FAX -IAIC, No Bat: INC, No: E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAICN INSURER A: Scottsdale Insurance Company 41297 INSURED Front Range Institute of INSURER 8: Travelers Indemnity Company 25658 Safety, Mark Rosoff dba: 1437 Summitview Drive INSURER C: 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 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 LTftINSIR TYPE OF INSURANCE ADDL SUER MD POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EX MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY X CPS1604548 06/27112 06127/13 DAMAGE TO RENTED PREMISES Ea occurrence $ ,OO,OO CLAIMS -MADE OCCUR MED EXP(Any one person) $ Excluded PERSONAL B ADV INJURY $ 1,000,00 X Prof Liab $1,000, GENERAL AGGREGATE $ 2,000,00 G 1 AGGREGATELIMIT APPLIES PER: PRODUCTS-COMPIOP ASS $ Excluded POLICY PRO- LOC $ - AUTOMOBILELIABILITY - M BISINGLE LIMIT EaCO accNED ident $ .- BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS I IAUTOS BODILY INJURY (Par accdent) $ PROPERTY DAMAGE Peraccident $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA IFUB9686C28A13 01/25/13 01/25114 X WC STATU- OTH- T RVLIMIT ER E.L. EACH ACCIDENT $ 10Q,00 EL.DISEASE - EA EMPLOYEE $ 10,00 If yes, describe under 'DESCRIPTION OF OPERATIONS below - E.L. DISEASE - POLICY LIMIT _ _ $ 500,0010 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Instruction in First Aid S CPR - City of Fort Collins is included as Additional Insured on the General Liability as respects the operations of the named insured per form CG2010 07/04 CITYF10 City of Fort Collins 215 N. Mason St. Fort Collins, CO 80521 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD