HomeMy WebLinkAbout315931 BIG THOMPSON WATERSHED FORUM - INSURANCE CERTIFICATE (6)ACORO® CERTIFICATE OF LIABILITY INSURANCE
DATE (t�LMND/YYYY)
12�z672014
THIS CERTIFICATEIS 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 SUBROGATIONIS WANED, 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
PAYCHEX INSURANCE AGENCY INC
210705 P: F:(888) 443-6112
PO BOX 33015
SAN ANTONIO TX 78265
CONTAcT
NAME:
(NC No.Ei¢
iAA'o.Ner (888) 443-6112
E BB
INSURER(S) AFFORDING COVERAGE NAICN
INSURER A: Twin City Fire Ins Co
INSURED
BIG THOMPSON WATERSHED FORUM
800 S TAFT AVE
LOVELAND CO 80537
INSURER B:
INSURER C:
INSURER D:
INSURER E:
INSURER
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.
"SR
PPE OF L'1'SIIRANCP
ADD
S!/R
PDLICF'.VU.IffiFJt
Pv""WF
�,1,1,I
MLNL XP
LDfITS
COMMERCIAL GENERAL LU191LRY
EACH OCCURRENCE
y
CLAIMS -MADE ❑OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
E
MED EXP (Any one Person)
E
PERSONAL B ADV INJURY
E
GENT AGGREGATE LIMIT APPLES PER:
GENERAL AGGREGATE
E
POLICY JEC ❑ LOG
PRODUCTS-COMP/OP AGG
$
OTHER
E
AUTOMOBILELNBILITY
COMBINED SINGLE LIMIT
(Ea arcllend)
E
BODILY INJURY (Per Person)
S
ANYAUTO
ALLOWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
5
PROPERTY DAMAGE
(Peracadent)
E
NON-0W NED
HIRED AUTOS AUTOS
E
UMBRELLA U&B
OCCUR
EACH OCCURRENCE
E
AGGREGATE
E
EXCESS LIAR
CLAIMS -MADE
DE
RETENTION E
5
a"ORl£.1S N.V+CVSn]]OA'
ATD EUPLOPEL4'LG/R.lf1
XI PER OTN-
GTAME JER
E.L. EACH ACCIDENT
100, 000
ANY PROPRIETORMARTNER/EXECUTIVEY/N
A
OFFICERfMEMBER EXCLUDED?
(MarduSayiM) ❑ n
xrA
76 WEG PE5980
01/01/2015
01/01/2016
E.L. DISEASE- EA EMPLOYEE
5100,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE -POLICY LIMIT
E50 00(]
DESCRIPTION OFOPERATRMISYLMATIONS/ VEHILIIIIIEURD 101, Addi mir al Ra..da, Schedule, may be attached U nHua apace is required)
Those usual to the Insured's Operations.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
The
City Of Fort Collins
Y
BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORMED REPRESEWATNE
Fort Collins WTP
LAPORTECOLLINS AVE
FORT
FORT
COLLINS, CO 80521
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD