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HomeMy WebLinkAboutFOOTHILLS GATEWAY INC - INSURANCE CERTIFICATE (4)Client#: 37379 FOOGA ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DO/YYYY) 6/11/2013 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 CONTACT Kelly Beauvais NAME PHONE 970-266-7121 FAx 970-506-6836 A/C No Ext : (A/Q No): E-MAIL ADDRESS: KBeauvais@FloodPeterson.com PRODUCER CUSTOMER ID It: INSURERS) AFFORDING COVERAGE NAICN INSURED Foothills Gateway, Inc. 301 West Skyway Drive Fort Collins, CO 80525 INSURER A: Philadelphia Insurance Companle INSURER BPinnacol Assurance 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 INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHIC CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR T TYPE OF INSURANCE DDL N RAVE UBR POLICY NUMBER POLICY EFF MM/DDNYYY POLICY EXP MM/DDNYYV LIMIT id A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR PHPK1033200 7/01/201307/01/201 EACH OCCURRENCE AD RE PREM SE ToES Ea oNcur epee MED EXP(Any one person) PERSONAL&ADV INJURY $,, GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY F7 PRO- LOB BET PRODUCTS - COMP/OP AGO $3,000,000 S A AUTOMOBILE LIABILITY ANV AUTO ALL OWNED AUTOS SCHEDULED AUTOS AUTOS NON -OWNED AUTOS PHPKI033200 7/01/2013 07/01/2014 COMBINED SINGLE LIMIT (Ea accident) $1 000000 BODILY INJURY(Per person( $ BODILY INJURY(Per accident) $ 1XX PROPERTY DAMAGEHIRED (Per accident)$ S $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS-0AADE PHUB424009 7/01/2013 07/01/201 EACH OCCURRENCE $2000000 AGGREGATE s2,000,000 X DEDUCTIBLE RETENTION $ 10 DDD $ S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below WA 703552 7/01/2013 07/01/201 X WGSTATU- OTH- EL EACH ACCIDENT $500,000 E L. DISEASE - EA EMPLOYEE $500,000 EL DISEASE -POLICY LIMIT S500,000 A Professional PHPK1033200 7/01/2013 07/01/201 $1,000,000 Ea. Incident $3,000,000 Aggregate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: Flying Pig Charity Run/Walk Fundraiser, April 14, 2013 Certificate holder, its officers, employees and agents are named as additional insured. City of Fort Collins 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 REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S792549/M792538 ___. KMM