HomeMy WebLinkAbout129790 THE FEET INC - INSURANCE CERTIFICATE (10)FEET-01 OP ID: JD
CERTIFICATE OF LIABILITY INSURANCE
DAT06/09DIYYYY)
os/osna
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
4532 Boardwalk Dr, Suite 200 Fax: 970.484-4165
Fort Collins, CO 80525
Tyler B. Allen
O
CONTACT
NAME:
FAX
gICNNo Ext INC. No):
EMAIL
ADDRESS:
INSURER(S) AFFORDING COVERAGE
MARC N
INSURER A: United Specialty Insurance Co.
12537
INSURED The Feet, Inc.
Velocity Boys, Inc.
622 Sherry Drive
Fort Collins, CO 80524
INSURER B : 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 INSURANCE
POLICY NUMBER
POLICY EFF
MMIDD/YYYV1
POLICY EXP
(MMIDDNYYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,00
D
X COMMERCIALGENERALLIABIUTY
CLAIMS -MADE 1XI OCCUR
PICC00003788
08115/13
08115114
PREMISES Ea occumance
$ 100,000
MED EXP(My one Person)
$ 10,000
PERSONAL &ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEWL AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY PRO-IFCT LOC
$
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
1,000,000
X
BODILY INJURY (Per person)
$
D
ANY AUTO
PICC00003788
08115113
08115114
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
BODILY INJURY aodtlent )
$
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAB
X
OCCUR
EACH OCCURRENCE
$ 2,000,000
X
AGGREGATE
Is 2,000,00
A
EXCESS LIAB
CLAIMS -MADE
USA4000159
08115/13
08115114
DEO I I RETENTION$ 0
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER,EXECUTIVE YIN
OFFICER(MEMBER EXCLUDED? FYI
NIA
3534074
07101/14
07/01/15
WC STATU- OTH-
X T RY MIT R
EL EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,00
(Mandatory In NH)
If yes, descliF OPERATIONS below he untler
DESCRIPTION O
E.L. DISEASE -POLICY LIMIT
$ 1,000,000
E
Empl Dish
PHSD945385
05128114
05128115
Limit 250,000
C
TranSICargo
MZ198470793
02/15/14
02/15/15
Limit 100,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required)
The City of Port Collins is included as an additional insured per conditions
and forme shown on page 2.
City of Fort Collins
Purchasing Division
Attn: Jim Hume
PO Box 580
Fort Collins, CO 80522-0580
CITYDIV
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
ACORD 25 (2010105)
n 1OHR-2010
The ACORD name and logo are registered marks of ACORD
All rin Me —.—A
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