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Home My WebLink AboutCOLORADO STATE UNIVERSITY OFFICE OF RISK MANAGEMEN - INSURANCE CERTIFICATEPS]LIIUlYWE ACOORoe CERTIFICATE OF LIABILITY INSURANCE 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 INSURERjS), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. N 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 endorsements). PRODUCER 1-303-536-6567 IRA, Inc. - Colorado Division CONTACT NAYS: NAME:PHON FA% No: ADDRESS: denyaM@imacorP.cam 1705 17th Street Suite 100 Denver, CO 80202 INSURERS AFFORDWO COVERAGE NAICa INSURER A: STARR IND 6 LIAB CO 38318 INSURED INSURER B: SAFETY HATE CAB CORP 15105 Colorado state University Office of Risk Naaaeemeat 4 Insurance INSURER C: TRAVELERS PROP CAB CO OF ArBR 25676 INSURER O: 161 Gen•l Sery Bldg -Campus Del 6002 INSURER E: Port Collins, CO 80523-6021 INSURER F : r:OVFRAr FR CFRTIFICATF MIIMRFR- 40529277 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. WSR LTR TYPE OF INSURANCE POLICY NUMBER MMLOYEFF PMMDYEXP LNUTS A GENERAL LMBLLmY 1000005219 07/01/1 07/01/15 EACH OCCURRENCE s 10,000,000 = COMMERCVILGENERAL DABILITY AMA RENTED PREMISES Ea . f INCLUDED CLAIMS -MADE Ifl OCCUR MEDEXP snap SEXCLUDED PERSONAL S ADV INJURY s INCLUDED X BIRr$500,000 Z Incl. Rost Lig Liab. GENERAL AGGREGATE $ 0 GENLAGGREGATE LIMIT APPLIES PER: PRODUCTS -wmpmP AGO $ 10,000,000 POl1CY PRO- Lot $ A AUrOYOBYE Lousurr 1000005219 COMBINED SINGLE LIMIT a a ri0en1 10, 000, 000 SODILYINJURY(PWpaOan) $ X ANYAUTO ALL OWNED SCHEDULED PX aoi BODILY IWURY(PWQ $ AUTOS AUTOS PROPERTYaDAMAGE s X X NON OWNED HIREDAUTOS $ SIR0500,0 0 UYBRELLALMB OCCUfl EACHOCCURRENCE S AGGREGATE $ EXCESS UAB CLAWS -MADE DED I I RETENTION F B WORKERS COMPEMBATM)N SP4051108 - CO ONLY 08/01/1 08/01/15 X WCSTATLL oiN AND EYPLOYERr LM91LITY YIN El, EACH ACCIDENT S 1, 000, 000 C ANY PROPRIETOHIPMTNERffACUPVE U86070N92A14 - ADS 07/01/1 07/01/15 OFHCERIMEMSER EXCLUDED? MIA E.L. DISEASE - EA EMPLOYE S 1, 000, 000 (Yantlabry In NH) Il yymm ee EN OF O OEBCRIPTION OF OPERATIONS tielwv E.L. DISEASE- POLICY LIMIT i 1, 000, 000 WORRBRS COMP®7SATIOR AM SP4051108 - CO ONLY- EMPLOYERS- LIABILITY ARetentlonr $500,000 (AOSWLII Other States) OESCRIPTMM OF OPERATIONS I LOCATKWS I VEHICLES(AU ACORD 101, AaellaW R< Ss0a . Moon aPary NrpuVM) Port Collins Adaptive Recreation Opportunities Program students - Level III Fieldwork ' of Port Collins e Murray, Risk Manager Office Box 580 Collins, CO BOS22-OSSO USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AVmgRRED REPRESE rAnVE All riahts reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD SDEM 40529277 IN P53NO2W2 g Q ) O CERTIFICATE OF LIABILITY INSURANCE Y"ldTHIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICTHISCERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDEDICIESBELOW. MAUTHORIZED THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUREIZEDREPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: N me Certificate holder Is an ADDITIONAL INSURED, the poliey(les) must be endorsed. N SUBROGATION IS ect to the terms and Conditions of the policy, Certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s . PRODUCER 1-303-536-6567 IMA, Inc. - Colorado Division CONTACT NAME: PHONE FAX A/C No E-$UUL deayemSimacozp. Cc® AWRE88. 1705 17th Street Suite 100 Denver, CO 80202 INSURERS AFFORDING COVERAGE MCI INSURERA: STARR IND A LIAB CO 38318 INSURED Colorado State University Office of Risk Macaoe st a Insurance INSURER B: SAPBTY NATL CAB CORP 15105 INSURER C: TAAVELHRB PROP CAS CO OF AMR a5676 INSURER D: 141 Gen•l Sery Bldg -Campus Del 6002 INSURER E: Port Collins, CO 80523-6021 INSURER I: COVFRAr FR rPC1"VICATF MIIMRCR- 60903060 0n 01^M Muumcm. 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, I LIN TYPE OF INSURANCE POUCYNUMSEfl POLICY MY ICY POLICY EXP D LIMITS A GENERALLNBILRY 1000005219 07/01/1 07/01/15 EACHOCCURRENCE $ 10,000,000 X COMMERCIALGENEMIJABILITY PREMISES oaurmnpe $ INCLUDED CLAIMS -MADE � OCCUR MEDEXP AM. man) $ EXCLUDED X SIR:$500,000 PERSONAL a ADV INJURY $ INCLUDED X Incl. Boot Liq Liab. GENERALAGGREGATE $ 0 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 10,000,000 POLICY PR0. LOC $ A AUTOMOBILE LIABILITY 1000005219 COMBINED SINGLE LIMIT His anIxIs.0 S 10, 000, 000 BODILYIWURY(PMpssnn) $ X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (PM awMrnQ $ X NON -OWNED HIRED AUTOS X AUTOS PROPERTY DAMAGE $ X BIR:$B00,0 0 $ UMBRELLA UAS OCCUR EACHOCCURRENCE f AGGREGATE f EXCESS UAB CLAIMS�MADE DED I I RETENnON $ B WORKERS COMPENSATION SP4051108 - CO ONLY OB/O1/1 OB/O1/15 WC STATU- OTH. X AND EMPLOYERS' UIUNUTY YIN E.L. EACH ACCIDENT f 11000,000 C ANYPROPRIETOHIPARTNERiEJ(ECIfRVE DB6070R92A14 - A08 07/01/1 07/01/15 OFFICER/MEMBER EJ(LLUOEOi O NIA E.L. DISEASE - EA EMPLOYE $ 1,000,000 (MrndaWry In NMI tlIPTION E.L. DISEASE - POLICY LIMB j 1,000,000 0ypS OFO DESCRIRTIONOFOPE192,TI NOARBRB COMPENSATION AMD JUN aP4051108 - CO ONLY BMPLOYMW- LIABILITY •Beteation: $500,000 (AOS=All Other States) DESCMI NOFOPERATONS/LOCATRNS/VEHICLES pLUNeNACORDd01,Addl WRx,MHu Us duN,Ifmomrprer Is, u6M) RE: Special Event Permit CSU Homecoming Parade October 17, 2014. City of Port Collins is included an Additional Insured on the General and Automobile Liability Policies if required by Mritten contract or agreement subject to the Policy terms and conditions. City of Port Collins Lance Murray - Risk Nanagement PO Box 580 Collins, CO 80572 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. USA I AUTHORIZED REPREBENTATWE //',/$k H ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD scarrillo 40803060 All riahts reserved. A