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HomeMy WebLinkAbout129790 THE FEET INC - INSURANCE CERTIFICATE (8)FEET-01 OP ID: JD A�Ro, CERTIFICATE OF LIABILITY INSURANCE 1 DATE02/11D/YVYY) z/11/1a 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 Phone: 970-482-7747 Brown & Brown Inc Fax: 970 484 4165 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 Tyler B. Allen INSURED The Feet Inc. Q 622 Sherry Drive 127 7 17 0 Fort Collins, CO 80524 NAMIl ' __ _ _ _ PHONE FAX A C No E : (AIC. No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL t INSURER A: United Specialty Insurance Co. 12537 INSURER e : PinnaCOl Assurance Company/ 41190 INSURER C : AGCS Marine Insurance Co. 22837 INSURER D: Praetorian Insurance Co. 37257 INSURER E : Philadelphia Indemnity Ins Co 18058 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. INSR LTR TYPE OF INSURANCEkDD SUB POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MWDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 PREMISES Eaoccunence $ 100,00 D X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx—] OCCUR PICC00003788 08/15/13 08/15/14 MED EXP (Any one person) $ 10,0001 PERSONAL$ ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS -COMPIOP AGG $ 2,000,00 POLICY PRO-ECT 7 LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,00 X BODILY INJURY (Per person) _ $ D ANY AUTO PICC00003788 08115113 08115/14 ALL OWNED SCHEDULED AUTOS AUTOS NON-OWNED HIRED AUTOS AUTOS $ $ BODILY INJURY (Per accident) PROPERTYDAMAGE Per accident UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,00 X AGGREGATE $ 2,000,00 A EXCESS LIAS CLAIMS -MADE USA4000159 08115/13 08/15/14 DED RETENTION$ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEYIN OFFICERIMEMBER EXCLUDED? EY-1 (Mandatory In NH) NIA 3534074 07/01/13 07101/14 X I WC STATU- OTH- TRY LIMITR E.LEACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 N yBS describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 E Empl Dish PHSD844894 05/28113 11121114 limit 250,000 C Trans/Cargo MZ198470793 02/15/14 02/15/15 Limit 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, Ifmom space is required) The City of Fort Collins is included as an additional insured per conditions and forms shown on page 2. Fax #221-6707 CERTIFICATE HOLDER CANCELLATION CITYDIV City of Fort Collins Purchasing Division Attn: Jim Hume PO Box 580 Fort Collins, CO 80522-0580 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 ww%' 9- ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD FEET-01 PAGE 2 NOTEPAD INSURED'S NAME The Feet, Inc. OP ID: JD DATE 02M1/74 f required by written contract, the following endorsements apply on a lanket basis: eral Liability: C0371 (08/09) General Liability Broadening Endorsement including Additional Insured 404 (05/09) Waiver of Transfer of Rights or Recovery Against Others To US Liability: -B (06/00) Additional Insured Endorsement Compensation: 9b Blanket Waiver of Subrogation