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HomeMy WebLinkAbout102831 LARIMER HUMANE SOCIETY DBA ANIMAL PROTECTIO - INSURANCE CERTIFICATEAls.- ® CERTIFICATE OF LIABILITY INSURANCE 7/8/2013 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 endorsements . PRODUCER First Mainstreet Insurance, LLC 275 S. Main Street, Suite 100 P.O. BOX 847 Longmont CO 80502 CONTACT Debbie McGee NAME: PHOAICNE (3O3)776-5122 FA% (303)776-5495 AppAg"Ess.dmcgee@firstmainstreet.com INSURERS AFFORDING COVERAGE NAIC It INSURERA:Great American Insurance CO. INSURED Larimer Humane Society I0�2 DBA: Larimer Animal Protection 6 Control 5137 South College Avenue Fort Collins CO 80525 INSURERB:Great American Assurance Co. INSURERC:Great American Alliance Ins CO INSURER D:Pinnacol Assurance INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:13/14 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 OF INSURANCE ADOL SUBR POLICY NUMBER POLICY EFF POLICY E%P M LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx1OCCUR PAC5373771 /1/2013 /1/2014 AMA TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person $ 10,000 PERSONAL $ ADV INJURY $ 1,000,0001 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY PIFr.TRO LOC $ AUTOMOBILE LIABILITY CEOMBINEDt SINGLELIMIT 1,000,00 BODILY INJURY (Per person) $ B ANY AUTO ALL OrEDSCHEDULED S373771 /1/2013 /1/2014 Ix ( )BODILY IWURV Per acddenf $ PROPERTY DAMAGE $ HIRED AUTOS X NON -OWNED Uninsured motorist Bl-sin le S 11000,000 X UMBRELLA DAB OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 L. EXCESS DAB CLAIMS -MADE LIED I X I RETENTION 10,00 $ 5373772 /1/2013 /1/2014 D WORKERS COMPENSATION WC $TATD- OTH- ANDEMPLOYERS'DABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMSER EXCLUDED? (Mandatory in NH) NIA 015370 /1/2013 {i/2014 LM E.L. EACH ACCIDENT $ 100 000 E.L. DISEASE - EA EMPLOYE $ 100 000 R yes. dose too under DESCRIPTION OF OPERATIONS bell" r E.L. DISEASE -POLICY LIMIT 1 $ 500,000 I DESCRIPTION OF OPERATIONS / LOCATIONS/ VEHICLES (Attach ACORD 101, Additional Remarks Schedule, H rnore space is required) Certificate Holder as Additional Insured as required by written contract per policy form. (970)224-6134 CD _1S City of Fort Collins Purchasing Department P O 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 ACORD 25 McGee/DEBMC ©1988-2010 ACORD CORPORATION. All riahfs resPrMPrI INS025 (201005) of The ACORD name and logo are registered marks of ACORD