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Home My WebLink About102831 LARIMER HUMANE SOCIETY DBA ANIMAL PROTECTIO - INSURANCE CERTIFICATE (2)L-ARIHUM-01 MMATHEWS ,4CORo' CERTIFICATE OF LIABILITY INSURANCE �i DATE(MM/DOIYYYY) 71212014 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 endomement(s). -- - - PRODUCER TrueNorth PO Box 847 - - - Longmont, CO 80502 CONTACT Debbie McGee - NAME: PHONE FAX _(aC No Ean: (303) 776-5122 AIc No): (303) 776-5495 truenorthcompanies.com ADDRESS: dmcgee@truenorthcompanies.com INSURERS) AFFORDING COVERAGE NAICN INSURER A: Great American Assurance Company 26344 INSURED Larimer Humane Society dba Larimer Animal Protection & Control 5137 South College Avenue Fort Collins, CO 80525 INSURER B: Great American Alliance Insurance Company 26832 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. INSR LTR I TYPE OF INSURANCE D POLICY NUMBER MMESUB DD/YYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERALLIABILITY CLAIMS-MADE T OCCUR PAC5373770 - - - 07/01/2014 07/01/2015 - EACH OCCURRENCE $ 1,000,00 -DAM PREMISES Ea occurrence $ 100,00 MED EXP(Any one person) $ 10,00 PERSONAL S ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY ❑ PRO ❑ LOC JECT_ OTHER: . . - .. GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGO $ 2,000,00 _ $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X X HIRED AUTOS AUTOS CAP5373771 07/01/2014 07/01/2015 COMBINEDSINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peracciden $t B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE UMB5373772 07/01/2014 07/01/2015 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DED I X RETENTION$ 10,000 $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? F1 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 4015370 07/01/2014 07/01/2015 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 100,00 E L DISEASE- EA EMPLOYE $ 100,00 E.L. DISEASE POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required) City of Fort Collins as Additional Insured as Required by Written Contract Per Policy Form. City of Fort Collins Purchasing Department 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 A4 01988.2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD