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Home My WebLink About315931 BIG THOMPSON WATERSHET FORUM - INSURANCE CERTIFICATEClient#: 41916 BIGTH1 ACORD CERTIFICATE OF LIABILITY INSURANCE F DATEIMM/DDJYYYY) 1/15/2013 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 Flood & Peterson Ins., Inc. - P. O. Box 578 Greeley, CO 80632 970 356-0123 I - I CONTACT — NAME: Mild Underwood - - - - PNDNE 970 356-0123 - 970 506-6820 A/C No Est: A/C, No: AOrkrE DREss: munderwoodQfloodpeterson.com CUSTOMER ID a: INSURER(S) AFFORDING COVERAGE NAIC If INSURED Big Thompson Watershed Forum 800 S Taft Ave INSURER A: Philadelphia Insurance COmpanie INSURER 8: Loveland, CO 80537 INSURER C 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. ]NSA LTjL TYPE OF INSURANCE %DDL3UBR POLICY NUMBER MMIDD/YFF MMIDDNYY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE El OCCUR ' EACH OCCURRENCE $ DAMAGE TRENTED— PREMISES Ea occurrence S MED EXP (Any one person) $ PERSONAL &AUV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: P17 OUCV .. PRO- LOG PRODUCTS - COMP/OP AGO .. .... $ ..... ...... AUTOMOBILE LIABILITY ' ANYAUTO ALLOWNEDAUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE UMIT (Ea accident) $ - BODILY INJURY(Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under DE SCRIPTION OF OPERATIONS below NIA WGSTATU- OTH- E.L. . ACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT I $ A Directors & Officers PHSD797698 1/13/2013 01/13/201 $1,000,000 Occurrence $1 000 000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Affach ACORD 101, Additional Pantries Scheclule, if more space is required) Attn: Judy Billica, PhD, PE, Senior Process Engineer & Watershed Manager City of Fort Collins - Fort Collins Water Treatment Facility 4316 LaPorte Avenue 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. AUTHORIZED REPRESENTATIVE 01988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 Oft #S758922/M758921 The ACORD name and logo are registered marks of ACORD MILLI