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HomeMy WebLinkAboutFRONT RANGE INSTITUTE OF SAFETY (MARK ROSOFF) - INSURANCE CERTIFICATE (2)FRINS-1 OP ID: P6 ,d►tcoRo CERTIFICATE OF LIABILITY INSURANCE DATE07123 D/YYYY) 1 7123114 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 endorsements . PRODUCER Phone:970482-7747 CONTACT Brown & Brown Inc Fax: 970-484-4165 4532 Boardwalk Dr, Suite 200INC, Fort Collins, CO 80625 House Account PHONE FAX No Eat: ac No): E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC M INSURER A: Scottsdale Insurance Cc 41297 INSURED Front Range Institute of INSURER B: Travelers Indemnity Company 25658 Safety Mark Rosoff dba: 1437 Summitview Drive INSURER C: Ft Collins, CO 80524 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 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 Atl UBR POLICY NUMBER EFF MMiODNYYY IDDPOLICY MM EXP POLICY IYYYY LIMITS GENERALLIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X CPS2012443 06/27/14 06127/15 PREMISES E.occumence S 100,00 MED EXP(Any one person) $ Exclude PERSONAL S ADV INJURY $ 1,000,00 X Prof Liab GENERAL AGGREGATE $ 2,000,00 A $1,000,000/$2,000,000 06/27/14 06/27/15 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPIOP AGG $ Exclude POLICY 7 PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per parson) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ HIRED AUTOS NON -OWNED AUTOS PROPERTY DAMAGE Per amdeni $ E UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTIONE $ B WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY ANY PROPRIETORIPARTNERIEXECUTIVE YIN El OFFICERIMEMBER EXCLUDED? (Mandatory in NH) IFUB9686C28A13 01/25/14 01/25/15 WC STAOTH- X T RY LIMITTU- E.L. EACH ACCIDENT $ 100,00 E.L.DISEASE-EAEMPLOYEE E 10,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-pOLICY LIMIT S 500,OD DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Adach ACORD 101, Additional Remarks schedule, If mom space Is required) Instruction in First Aid & CPR - City of Fort Collins is included as Additional Insured on the General Liability as respects the operations of the named insured per form CG2010 4-13 CITYF10 City of Fort Collins 215 N. Mason St. Fort Collins, CO 80521 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 ©1988.2010 ACORD CORPORATION. All rights reserved ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD