HomeMy WebLinkAbout130574 LARIMER COUNTY CHILD ADVOCACY CENTER INC - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE
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DATE IMMIDD/YVYYI
12-22-2014
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 INSURERIS). AUTHORIZED REPRESENTATIVE
OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(iss) 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:
51601 / Ramsgate Insurance Inc
PHONE
FAX
250 East Park Avenue
A/C No, Ext):
(A/C No):
E-MAIL
Lake Wales, FL 33853
-
ADDRESS: "
INSURER(S) AFFORDING COVERAGE
NAIC U
INSURED
INSURER A: MARKEL INSURANCE COMPANY
INSURER B:
Larimer County Child Advocacy Center, Inc.
INSURER C:
'.. 5529 S Timberline Road
INSURER D:
Fort Collins, CO 80528
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.
NSF
ADOL
SUER
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
MEN
WVD
POLICY NUMBER
MMIDDrYYYY
IMMIDWYYYY)
LIMITS
A
GENERAL UASILRY
EACH OCCURRENCE
_ _
r 1,000,000
DAMAGE TO RENTED
PREMISES (Ea occurrencel
a 100,000
® COMMERCIAL GENERAL LIABILITY
❑❑ CLAIMS -MADE ® OCCUR
❑
®
❑
8502SS390021-2
03-09-2015
03-09-2076
VIED EXP IAny . pereonl
r 5,000
PERSONAL aADVINJURY
a 1,000,ODO
_
❑
GENERAL AGGREGATE
a 3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
0.
❑ POLICY ❑ 7ECT ❑ LOC
PRODUCTS - COMP/OP ADD
F 1,000,000
r
AUTOMOBILE LABILITY
❑ ANY AUTO
❑
❑
-
COMBINED SINGLE LIMIT
(Ea accident)
r
BODILY INJURY (Per person)
t
❑ ALL OWNED ❑ SCHEDULED
AUTOS AUTOS
PION -OWNED
❑ HIRED AUTOS ❑ AUTOS
❑ ❑
BODILY INJURY IPer accident)
t
PROPERTY DAMAGE
Per accident)
r
e
UMBRELLA UAB
® OCCUR
❑
❑
EACH OCCURRENCE
e
EXCESS UAB
CLAIMS -MADE
AGGREGATE
❑ DED ❑ RETENTION F
1
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOIVPARTNERIEXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
NIA
❑
❑ WC STAN- ❑ OTH-
MIRY LIMITS ER
E.L. EACH ACCIDENT
r
E.L. DISEASE - EA EMPLOYEE
a
(Menda" in NH)
It yea, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
a
❑
❑
DESCRIPTION OF OPERATIONMOCATIONSnrEHICLES lArtacti ACORD 101. Additional Remarks SchNiM. N more specs la required)
Certificate holder is included as additional insured for operations conducted by the named insured.
CERTIFICATE HOLDER
Fort Collins Police Department
2221 South Timberline Road
Fort Collins, CO 80528
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY
PROVISIONS.
AUTHORIZED REPRESENTATIVE
Bruce A. Kay
BWA
10
ACORD 25(2010/05)
(c)1988-2010
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