The URL can be used to link to this page

Home My WebLink About105737 FORT COLLINS SYMPHONY ASSOCIATION - INSURANCE CERTIFICATEFORTCOL-02 MTUSINSKI ,acoRO' CERTIFICATE OF LIABILITY INSURANCE �� DATE (MM/DD/YYYY) 5/27/2014 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 endorsement(s). — PRODUCER TrueNorth - - PO Box 847 "- - -- Longmont, CO 80502 _ CONTACT Michelle Tusinski - NAME: _PHOONE Ex1 a303) 776-5122 - ac_No: (303) 776.5495 E-MAIL . ADDREss: mtusinski@truenorthcompanies.com - INSURER(S) AFFORDING COVERAGE RAID d INSURERA: Great American Insurance Company 16691 INSURED Fort Collins Symphony Association P O Box 1963 Fort Collins, CO $0522 INSURER B : Great American Alliance Insurance Company 26632 INSURER C: Pinnacol Assurance Company 41190 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 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. IEFF LTR TYPE OF INSURANCE A�LLTSUBR POLICY NUMBER MM POLICY ODIYYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE _UA❑X $ 1,000,00 CLAIMS -MADE OCCUR PAC1670641-03 06/01/2014 06/01/2015 PREMISES Eaoccurrence PREMISES $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ - 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMPIOP AGO $ -—2,000,00 POLICY ❑ PRO ❑ LOC. JECT $ OTHER. OMOBILE LIABILITY INGLE LIMIT Ea accitlenl $ 1,000,00 BODILY INJURY(Per person) $ AANY AUTO .PAC1670541-03 06/01/2014 06/01/2015 BODILY INJURY (Per accitlenl) $ AUTOOS SCHEDULED HREDAUTOS X AUTOSAUTOS WNED P Pern OP.ER-DAMAGE $ S X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,00 LJ AGGREGATE $ B EXCESS LIAB CLAIMS -MADE UMB1670542 06/01/2014 06/01/2015 DED I X I RETENTION$ 10,000 Is 1,000,00 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN 4144211 06/01/2014 06101/2015 PER OTH- STATUTE ER E.L.EACHACCIDENT $ 1,000,00 OFFICER/MEMBER EXGLUDEUi (Mandatory in NH) NIA E. L. DISEASE - EA EMPLOYEE $ 1,000,00 E. L. DISEASE - POLICY LIMIT $ 1,000,00 If yes, describe under DE SCRIPTION OF OPERATIONS below A Liquor Liability PAC1670541-03 06/01/2014 06/0112015 Occurrence 1,000,00 A PAC1670541-03 06101/1014 0610112015 aggregate 1,000,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) The City of Fort Collins, its officers, agents, employees, and volunteers are Additionally Insured as it relates to the City of Fort Collins Lincoln Center for the 2013-2014 Fort Collins Symphony season. GPJaP19C1 City of Fort Collins Risk Management PO 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 (A ,"AL� ll 1Y00-LVI4 HM VRV V VRt"VRN I IV re. Nu uaJum rcac, vcu. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD FORTCOL-02 MTUSINSKI CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 5/27/2014 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 certificateholder in lieu of such endorsement(s). PRODUCER TrueNorth PO Box 847 _ .. _. Longmont, CO 80502 CONTACT Michelle Tusinski _ NAME: PHONE (303)776-5122 FAX Ne:(303)776.5495 A/c rf_ eYO: ADDRESS: mtusinski@truenorthcompanies.com - INSURER(S)AFFORDING COVERAGE NAICe INSURERA: Great American Insurance Company 16691 INSURED INSURER B: Great American Alliance Insurance Company 26832 Fort Collins Symphony Association INSURERC: Pinnacol Assurance Company 41190 P O Box 1963 INSURER D : INSURER E: Fort Collins, CO 80522 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 LTRINSD TYPE OF INSURANCE ADDL SUaR POLICY NUMBER MM DD,,W MM/DDIVYYY LIMITS A X COMMERCIAL GENERALLIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMSMADE LJ OCCUR PAC1670541-03 06/0112014 06I01I2015 PREMISES(EaS 100,00 MED EXP (Anyone person) $ 5,00 yt PERSONAL 8 ADV INJURY $ 1,000,00 GENL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 1 RI - POLICY PRO- JECT❑ LOG PRODUCTS -COMPIOP AGG $_ - 2,000,00 $ OTHER: LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,606,00 BODILY INJURY (Per person) $ AANY AUTO PAC1670541-03 0610112014 06/01/2015 BODILY INJURY (Per accident) $ POMOBILE ALL OWNED SCHEDULED AUTOS AUTOS X NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ X UMBRELLALIAB OCCUR EACH OCCURRENCE $ 1,000,00 AGGREGATE $ B EXCESS LIAR CLAIMS MADE UMB1670542 0610112014 06101/2015 DIED I X I RETENTION$ 10,000 $ 1,000,00 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y/❑N OFFICERIMEMOER EXCLUDED? (Mandatory in NH) N/A 4044291 06/01/2014 06/01/2015 PER OTH- STATUTE ER E.L_EACH ACCIDENT $ 1,000,0D E. L. DISEASE - EA EMPLOYEE $ 1,000,00 EL DISEASE -POLICY LIMIT 1 $ 1,000,00 If yes describe under DESCRIPTION OF OPERATIONS be. A Liquor Liability PAC1670541-03 06/01/2014 0610112015 Occurrence 1,000,00 A PAC1670541.03 06/01/2014 0610112015 aggregate 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) the City of Fort Collins, its officers, agents, employees and volunteers are additionally Insured as it relates to the Beat Beethoven 5 K which will be held on 4/6/2014. City of Fort Collins - Risk Management 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 All riohts reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD