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HomeMy WebLinkAbout174626 FORT COLLINS HABITAT FOR HUMANITY INC - INSURANCE CERTIFICATEOP ID: AB CERTIFICATE OF LIABILITY INSURANCE DATE04119N 3/73 ) 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 ISSUINC INSURER(6), 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 970-945-9111 Neil-Garing Agency, Inc. PO Box 1576 - � 970-945-2350 Glenwood Springs, CO 81602 Jason W. Bolton �'1 CONTACT NAME: PHONE FAX AIc Ne Ea: AIL No: E-MAIL ADDRESS: PRODUCER FORTC-1 CUSTOMER ID s: INSURER(S) AFFORDING COVERAGE NAIC4 1 INSURED Fort Collins Habitat for INSURER A: PInnacol Assurance Humanity, Inc. 4001 South Taft Hill Rd INSURER B: Fort Collins, CO 80526 INSURER C: INSURER D : INSURER E : INSURER F: COVERAGES CERTIFICATE NUMBER: 1 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. ILTR TYPE OF INSURANCE DL R POLICY NUMBER POLICY EFF MMOOIYYri POLICY EXP MMIDDIYYri LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE PREMISES Ea occurrence $ MED EXP(Any one person) $ CI -AIMS -MADE ❑OCCUR PERSONAL B ADV INJURY $ GENERAL AGGREGATE 5 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ POLICY PRO-LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accIdemi $ ANY AUTO BODI LY I NJURV(Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS HI RED AUTOS PROPERTY DAMAGE (Per accident) $ $ NON-OWNEDAUTOS UMBRELLA LIAR OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DEDUCTIBLE $ s RETENTION $ A WORNERS COMPENSATION ANDEMPLOYERS'LIABILIIY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? ❑Y NIA 4154946 64161113 84101/14 x WC STATU- X OTH- T V IMIT R E.L. EACH ACCIDENT E 1,000,00 E. L. DISEASE -EA EMPLOYE $ 1,000,00 IMandatory In NH) If yes, descnce under DESCRIPTION OF OPERATIONS below EL. DISEASE -POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES IAnach ACORD 101, Additional Remarks Schedule, if mom space is required) CITYOFF City of Fort Collins Maggie McLancy PO Box 580 Fort Collins, CO 80522 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 REPRESE�NJTATWE © 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD