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Home My WebLink About286209 BOULDER COUNTY COLORADO - INSURANCE CERTIFICATE (4)ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD YVYY) 1 /14/2014 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 CONTACT NAME: PHONE FAX xt AC No: Arthur J. Gallagher Risk Management Services, Inc. 6399 S. Fiddler's Green Cir., #200 Greenwood Village CO 801114949 E-MAILS ADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 INSURER Absurance Company of State of PA 19429 INSURED BOULCOU_02 INSURER B : INSURER C: BOULDER COUNTY COLORADO pp. INSURER D: ATTN: MS. PAM STONECIPHER 206 Zo 2025 14TH STREET, FIRST FLOOR, BOULDER CO 80306 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 284795'49? 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 rypE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DDfYYYY POLICY EXP MM/DDfYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IT] OCCUR X $250,000 SIR 37723018 1/1/2014 /1/2015 EACH OCCURRENCE $Included DAMAGE TO RENTED PREMISES Ea occurrence $Included MED EXP Any one person) $None PERSONAL & ADV INJURY $Included GENERAL AGGREGATE $10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICYF7 CT PRO- LOC JE PRODUCTS - COMP/OP AGG $10,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIREOAUTOS AUTOS COMBINED STRI3rETT9rr__ Ea accident BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ S UMBRELLA UAB EXCESS UAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR EXCLUDED? ECUTIVE ❑ OFFICER/MEM(Mandatory H) EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- RY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR TO THE GENERAL LIABILITY POLICY. CITY OF FORT COLLINS ATTN: PURCHASING DIVISION PO BOX 580 FORT COLLINS CO 80522 USA 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 (c)19Stl-2U1U AGUKU GUKF VKAI IUN. All rlgnis reservea. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD 000421