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HomeMy WebLinkAbout129790 THE FEET INC - INSURANCE CERTIFICATE (6)From:Morgan Fugate FaxID:(970) 484-4165 Page 1 of 1 Date:2/15/2013 08:17 AM Page:1 of 1 FEET-01 OP ID: FM ,4�o�Ro CERTIFICATE OF LIABILITY INSURANCE DATDVVVV) 02115 02/15/13 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 endorsements . PRODUCER Phone: 970482-7747 Brown & Brown Inc Fax: 970484-4165 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 Tyler B. Allen CONTACT NAME PHONE FAX A/C No Ext : (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURER A: PInnacol Assurance Company 41190 INSURED The Feet, Inc. INSURERB: Philadelphia Indemnity Ins Co 18058 622 Sherry Drive Fort Collins, CO 80524 INSURER C:AGCS Marine Insurance Co. 22837 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. NOTVVITHSTAN DING 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 LTR rypE OF INSURANCE ADDL INSR SUBIR NND POLICY NUMBER POLICY EFF MMIDD/YVVV POLICY EXP MMIDD/YVVV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS-MADE1:1 OCCUR MED EXP (Any one person) $ PERSONAL & ADS INJURY $ GENERAL AGGREGATE $ GENL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OPAGO $ POLICY PECROT LOC J $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Edacadent $ BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED ITIFEDAUTO S AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ A WORKERS COMPENSATION ANDEMPLOVERS'LIABILITY ANY PROPRIETOR/PnRTNER/ExecuTlvE YIN OFFICER/MEMBER EXCLUDED? Ly] (Mandatory in NH) N/A 3534074 07/01/12 07/01/13 X WCSTAT U- OTH- TWOLIMITS ER E.L. EACH ACCIDENT $ 1,000,000 EITDISEASE- EAEMPLOYEE $ 1,000,000 If yes describe under DESCRIPTION OF OPERATIONS below EL.DISEASE-POLICY LIMIT $ 1,000,000 B Empl Dish PHSD46312 05/28/12 05/28/13 Limit 250,000 C Trans/Cargo MZ198470793 02/15/13 02/15/14 Limit 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Fax #221-6707 CERTIFICATE HOLDER CANCELLATION CITYDIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City Of Fort Collins Purchasing Division Attn: Jim Hume AUTHORIZE REPRESENTATIVE Allen Tyler B. Allen PO Box 580 Fort Collins, CO 80522-0580 ACORD 25 (2010105) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD