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Home My WebLink AboutCORRESPONDENCE - BID - 7093 COURIER SERVICE - LIBRARY DISTRICT (14)CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 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 CONTACT NAME: PHONE FAX (A/C, No, Ext): (A/C, No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : INSURED INSURER B : INSURER C : 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ POLICY PRO- LOC $ JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY TORY LIMITS ER Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N / A (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NOTEPAD INSURED'S NAME DATE PAGE FEET-01 2 The Feet, Inc. OP ID: JD 01/21/15 If blanket required basis: by written contract, the following endorsements apply on a General Liability: QBCG0371 (08/09) General Additional Liability Insured Broadening Endorsement including CG2404 (05/09) Waiver Others of To Transfer US of Rights or Recovery Against Auto Liability: ADDLINS-B (06/00) Additional Insured Endorsement Workers Compensation: 359b Blanket Waiver of Subrogation 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 FEET-01 OP ID: JD 01/21/15 Phone: 970-482-7747 Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 Fort Collins, CO 80525 Tyler B. Allen Fax: 970-484-4165 Great American E&S Ins. Co. 37532 The Feet, Inc. Pinnacol Assurance Company 41190 Velocity Boys, Inc. 622 Sherry Drive Fort Collins, CO 80524 AGCS Marine Insurance Co. 22837 Praetorian Insurance Co. 37257 Philadelphia Indemnity Ins Co 18058 1,000,000 D X PICCO0004133 08/15/14 08/15/15 100,000 X 10,000 1,000,000 2,000,000 2,000,000 1,000,000 D X PICCO0004133 08/15/14 08/15/15 X 2,000,000 A X XS3306050 08/15/14 08/15/15 2,000,000 0 X B 3534074 07/01/14 07/01/15 1,000,000 Y 1,000,000 1,000,000 E Empl Dish PHSD945385 05/28/14 05/28/15 Limit 250,000 C Trans/Cargo MZI98470793 02/15/14 02/15/15 Limit 100,000 The as Additional City of Fort Insureds Collins per and the The conditions Poudre River and Library forms shown District on page are 2. included PDRIVER Poudre River Public Library District and City of Fort Collins 201 Peterson Street Fort Collins, CO 80521