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HomeMy WebLinkAboutFRONT RANGE INSTITUTE OF SAFETY - INSURANCE CERTIFICATE (6)FRINS-1 OP ID: 1C ,4�aEz® CERTIFICATE OF LIABILITY INSURANCE F DA701127DIYVYY) o, /27/, a 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 PRODUCER Phone: 970-482-7747 Brown & Brown Inc Fax: 970 484 4165 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 House Account NAMEAy1 PHONE FAX ac No Ext: I (AIC, No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC e INSURER A: Scottsdale Insurance Company INSURERB:Travelers Indemnity Company 41297 25658 INSURED Front Range Institute of Safety, Mark Rosoff dba: 1437 Summitview Drive Ft Collins, CO 80524 INSURERC: 1 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 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. IICY �TR TYPE OF INSURANCEJNM POLICY NUMBER MMIDDNYYY EXP MMLDDNYYY LIMITS GENERAL I'A LITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X CPS1807905 06/27/13 06127/14 -5AMAM70 RENTED PREMISES Ea occurrence) f 100,00 MED EXP (Any one person) $ Exclude PERSONAL &ADV INJURY $ 1,000,00 X Prof Liab GENERAL AGGREGATE $ 2,000,00 A $1,000,000 06/27/13 06/27/14 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S Exclude POLICY 7 PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) S ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accitlent $ HIRED AUTOS NON -OWNED AUTOS $ UMBRELLA LJAB OCCUR OCCUR EACH OCCURRENCE E AGGREGATE $ UM' , LIAR DED RETENTION S B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) MIA IFUB9686C28A13 01/25/14 01/26/15 X WC STATU- OTH- E.LEACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE S 10,00 tl yes, describe under DESCRIPTION OF OPERATIONS belay E.L. OISEABE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Instruction in First Aid & CPR - City of Fort Collins is included as Additional Insured on the General Liability as respects the operations of the named insured per form CG2010 4-13 CITYF10 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 215 N. Mason St. Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE AAA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/06) The ACORD name and logo are registered marks of ACORD