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HomeMy WebLinkAbout233452 THE FAMILY CENTER LA FAMILIA - INSURANCE CERTIFICATEFAMI-03 OP ID: SM lai� CERTIFICATE OF LIABILITY INSURANCE DATE (MMIO N YY) 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 303-799-0110 Cherry Creek Ins. Agency, Inc. 303-799-0156 Suite 600 5660 Greenwood Plaza Blvd. NAMEACT Stephanie Malia PHONE 720-212-2028 Fax ac No Ext)' (AIC No): 303-799.0156 EMAIL ADDRESS: StephanieM@thinkccig.com Greenwood Village, CO 80111 Cherry Creek Insurance Agcy 7/ I INSURER(S) AFFORDING COVERAGE NAICN INSURER A: PInnacol Assurance 41190 INSURED The Family Center La Familia Stephane Tillman 309 Hickory #5 Fort Collins, CO 80524 INSURERS: Philadelphia Insurance Company INSURER C INSURER D: INSURER E : INSURER F nnVFRAnFC CFRTIFICATE 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 LTR TYPE OFINSURANCE AD POLICY NUMBER MMDDNYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 B X COMMERCIAL GENERAL LIABILITY X PHPK1029393 06/02/13 06/02/14 ao PREMISES Ea occurrence PREMIMAGE SES $ 100,00 CLAIMS-MADElxl OCCUR MED EXP(Any one person) $ 5,00 PERSONAL B ADV INJURY S 1,000,00 X Abuse/Molesation GENERAL AGGREGATE $ 3,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO $ 3,000,00 Abuse $ 1,000,00 POLIJ'CTCY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident S 1,000,00 BODILY INJURY (Per person) $ B ANY AUTO PHPK1029393 06/02/13 06102114 BODILY INJURY (Per accident) S ALLOWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE $ $ UMBRELLA DAB OCCUR EACH OCCURRENCE S AGGREGATE S EXCESS LIAR CLAIMS -MADE DED RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICEWMEMBER EXCLUDED? ❑ (Mandatory in NH) N / A 4031427 08101112 08/01113 WC STATU- OTH- TORV LIMIT ER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 E.L. DISEASE - POLICY LIMIT $ 500,00 IfYY Cescnbeun, DESCRIPTION OF OPERATIONS below B Property Section PHPK1029393 06102/13 06102/14 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarts Schedule, If more space Is required) Per written contract or written agreement, the Certificate holder is listed as Additional Insured under the General Liability where there interests may appear with respects to operations of the Named Insured. CERTIFICATE HOI DFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins tY THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 300 Laporte Ave Fort Collins, CO 80521-2719 AUTHORIZED-RE-�P-,R�ES`\ /ENTAATTIIVV�E� . © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD