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Home My WebLink About315931 BIG THOMPSON WATERSHED FORUM - INSURANCE CERTIFICATE (4)�Z ® CERTIFICATE OF LIABILITY INSURANCE ACORO i2i(22/201 3 THIS CERTIFICATEIS 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 SUBROGATIONIS 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 PAYCHEX INSURANCE AGENCY INC 210705 P: F: (888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAM : ac Ne.ExI): A/C Nor (888) 443-6112 EAAL ADDRESS: INSURER(S) AFFORDING COVERAGE NAICN INSURERA: Twin City Fire ins CD INSURED � 1 �(� � � yI BIG THOMPSON WATERSHED FORUM 800 S TAFT AVE LOVELAND CO 80537 INSURER B : 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 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. IAY'R L TA.1L11,DD/1T'37 TIPEOF1,%SIRaA'CE ADD SIB B POLICTNEER POLICT£FF POLICFEAP LLUITS GENERAL LLIBILIn' EACH OCCURRENCE COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurtence CLAIMS -MADE OCCUR MED EXP (Any one person) 5 PERSONAL d ADV INJURY g GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 5 POLICY PRO- LOC AL70-110SILELLIBILITY COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Par Pelson) ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) HIRED AUTOS NON -OWNED AUTOS UMBRELLA LIA8 OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS -MADE AGGREGATE 5 DE RETENTIONS 5 NOR1'L&SCO.VPGvSa7W% aAD ENPL0151S"LLUILLITY X wC 8LIMTATERS T00.Y LIMITS RS E.L. EACH ACCIDENT ' 1 00 10 0 0 ANY PROPRIETOR/PARTNER/EXECUTIVEYIN A OFFICER/MEMBER EXCLUDED? (Mandatory in NO) � NiA 76 WEG FE5580 01/01/2014 01/01/2015 E.L. DISEASE- EA EMPLOYEE 5100 r 000 E.L. DISEASE -POLICY LIMIT ° 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTXW OFOPERATLONS I LOCATIONS /VEHICLES (MAX Lino Length Is 70, Attach ACORD 101, Additional Remarks Schedule, If mom span /s Agleredl Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The City Of Fort Collins Y BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Fort Collins WT P LAPORTECOLLINS AVE FORT COLLINS, CO 80521 FORT 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD DST 00071920 PAYCHEX INSURANCE AGENCY INC PO BOX 33015 SAN ANTONIO TX 78265 AB 01 018199 53133 B 83 C IylIIII,IIIIIIIIII11.1'1I111'1��11��1-111,FI�J��I111��11�� The City Of Fort Collins Fort Collins WTP 4316 LAPORTE AVE FORT COLLINS CO 80521-2153 ACORD 25 (2010/05)