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Home My WebLink AboutRECREATION SYSTEMS II - INSURANCE CERTIFICATERECRSYS-01 MSWAIM ,acoRo' CERTIFICATE OF LIABILITY INSURANCE DATIYYYY) 713012 D30/2014 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 endorsements . PRODUCER Forsberg Engerman Co 3575 S Sherman St Englewood, CO 80113 CONTACT NAME: PHONE FA% A/c No at : 303) 762-1717 Alc No): (303) 762-1733 E-MAIL INSURER(S) AFFORDING COVERAGE NAIC p INSURER A: EMC Insurance Companies 21415 INSURED INSURER B:PInnacol Assurance 41190 1INSURER C : Recreation Systems II INSURER D P.O. BOX 98 Commerce City, CO 80037-0098 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 POLICY NUMBER MMIL ICY EFF DONYYYY POLICY EXP IIY MMIDDYYY UNITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE FxI OCCUR 31327098 07/28/2014 07/28/2015 PREMISES Ea occurrence) $ 100,00 MED EXP (Any one person) $ 5,00 PERSONAL& ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY 7X PRO- JECT LOG PRODUCTS - COMPIOP AGG $ 2,000,00 $ OTHER'. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,00 BODILY INJURY(Per person) $ A ANY AUTO 3E27098 07/28/2014 07/28/2015 ALL OWNED SCHEDULED AUTOS AUTOS JX BODILY INJURY (Per accitlenq $ X NON -OWNED HIRED AUTOS AUTOS PROPERTYDAMAGE Per accident S UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CIAIMS-MADE DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED' NIA 1090950 04/01/2014 04/01/2015 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE -POLICY LIMIT $ 500,00 A Inland Marine 3C27098 07/28/2014 07/28/2015 Limit 25,00 A Inland Marine ITI 3C27098 07/28/2014 07/28/2015 Contractors Equip 22,731 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached U more space Is required) Project: City of Ft Collins Reliant Park City of Ft Collins 215 N Mason St Fort Collins, CO 80524 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 4 ACORD CORPORATION. All rights reserved ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD