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HomeMy WebLinkAboutCORRESPONDENCE - AGREEMENT MISC - BICYCLE COOPERATIVE OF FORT COLLINS (5)CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS INSURERS AFFORDING COVERAGE COVERAGES CERTIFICATE HOLDER CANCELLATION ACORD 25 (2001/08) © ACORD CORPORATION 1988 DATE (MM/DD/YYYY) PRODUCER INSURED INSR LTR SCHEDULED AUTOS TYPE OF INSURANCE POLICY NUMBER HIRED AUTOS POLICY EXPIRATION DATE (MM/DD/YY) NON-OWNED AUTOS LIMITS GENERAL LIABILITY GARAGE LIABILITY EXCESS/UMBRELLA LIABILITY WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL AUTHORIZED REPRESENTATIVE 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSURER A: INSURER B: INSURER C: INSURER D: COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR ANY AUTO EACH OCCURRENCE COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EA ACC AGG EACH OCCURRENCE ACORD 25 (2001/08) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. INS025 (0108).06 Page 2 of 2 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). AMS AGGREGATE TORY WC STATU- LIMITS OTH- ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ INS025 (0108).06 INSURER E: GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO- JECT LOC OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. VMP Mortgage Solutions, Inc. (800)327-0545 Page 1 of 2 NAIC # POLICY EFFECTIVE DATE (MM/DD/YY) ADD'L INSRD DAMAGE PREMISES TO (Ea RENTED occurrence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below $ AMS 01/10/2011 (970) 484-2805 John C. Beckett & Associates, Inc. 220 Smith Street Ft. Collins CO 80524- Bicycle Cooperative of Fort Collins 331 North College Ave. Fort Collins CO 80521- MAX SPECIALTY INSURANCE UNITED STATES LIABILITY PINNACOL ASSURANCE A X X X MAX028800000236 10/21/2010 10/21/2011 1,000,000 100,000 5,000 1,000,000 2,000,000 INCLUDED / / / / / / / / / / / / NO COVERAGE / / / / / / / / / / / / / / / / NO COVERAGE / / / / NO COVERAGE / / / / / / / / C PENDING 11/11/2010 11/11/2011 X 100000 100000 500000 / / / / B Directors & Officers NDO1070031A 06/11/2010 06/11/2011 EACH CLAIM 500,000 Liability / / / / AGGREGATE 500,000 / / / / CERTIFICATE HOLDER IS AN ADDITONAL INSURED WITH RESPECTS TO THE GENERAL LIABILITY POLICY FOR THE ONGOING OPERATIONS OF THE INSURED ( ) - (970) 224-6134 CITY OF FORT COLLINS P.O. BOX 580 FORT COLLINS CO 80522- 10