HomeMy WebLinkAbout120140 VARSITY FACILITY SERVICES - INSURANCE CERTIFICATE (2)Client#: 207724
32VARFACI
ACORD,. CERTIFICATE OF LIABILITY INSURANCE
D01109/2014ATE Y1
01/0912014
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(les) must be endorsed. If SUBROGATION IS WANED, 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
Hub Int'I. Mountain States Ltd
PO Box 968
10 West Judicial Street
Blackfoot, ID 83221
CONTACT
NAME:
PHONE
LAIC No xt: 208.522-1260 2F'�— 08-522.1267
EAA:, No:
E-MAIL
ADDRESS:
INSURER(S) a
Property CasuaRIG lty
INSURER A: Travelers Property Casualty Co
74
25674
INSURED
Varsity Facility Services
/
Varsity Contractors, Inc dba 120I4 0
PO Box 1692
INSURERS: St Paul Fire and Marine Insuran
24767
Travelers Casual and Sure C
INSURERC: Casualty Surety
19038
INSURER D:
Pocatello, ID 83204
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 CONTRACTOR 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
ADD L
B
POLICY NUMSER
POLIC
MMIDOY E
P L Y EIfP
MMID
LETS
A
GENERALLIABLITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
x
TC2JGLSA1761B75413
TC2JCAP1761B74213
9/01/2013
0910M01A
EACH OCCURRENCE
$1 000000
PREMISES EeEONcwT�mnn
$500000
MED EXP(Any one person)
sN/C
PERSONAL S ADV INJURY
$1000000
GENERAL AGGREGATE
52,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO- LOC
PRODUCTS - COMP/OPAGG
52000,000
$
A
AMOMOWLELIABILITY
X
X
ANY AUTO
ALL OWNED SCHEDULED
AUTOS
HIRED AUTOS X NONOWNED
AUTOS
9/01/2013
09/01/201
� INED SINGLE apt LIMIT
1,000,000 _
$
BODILY INJURY (Per pence)
BODILY INJURY (Per aaldent)
ItAUTOS
$
PROPERTYAGE
Per ctl 1
S
B
X
UMBRELLAL"
EXCESS LIAR
OCCUR
CLAIMS -MADE
ZUP11P9636213NF
9/01/2013
09/01/2014
EACHOOCURRENCE
$19000000
N
AGGREGATE
$19 000 000
DED X RETENTION $1 0000
IS
A
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE YIN
OFFICER/MEMBER EXCLUDED?
(Myaendatory In NH)
DESCRIPTION OPERATIONS bIo-a
NIA
TC2JUB1761B69813
_
105667657
9/01/2013
09/0112014
X WCSTATU- OTrb
E.L. EACH ACCIDENT
$t 000 000
EL. DISEASE -EA EMPLOYEE
$1000000
EL. OISEPSE- POLICY LIMIT
$1000000
C
Employee Theft
9101/2013
09/011201
Llmh $1,000,000
3rd Party $2,500,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is reRuired)
Certificate holder, City of Fort Collins, its officers, agents and
employees are covered in accordance with the terms of the General
Liability Blanket Additional Endorsement CGD246.
City of Fort Collins
Doug Clapp - Senior Buyer
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
01988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) 1 of t
#S502750/M419768
The ACORD name and logo are registered marks of ACORD
THA2