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HomeMy WebLinkAbout129790 THE FEET INC - INSURANCE CERTIFICATE (12)FEET-01 OP ID: JD CERTIFICATE OF LIABILITY INSURANCE DATEIM09/1YVV) 02/9115 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 Phone: 970-482-7747 CONTACT Brown & Brown Inc NAME. 4532 Boardwalk Dr, Suite 200 Fax: 970 484-4165 PNO N Ext : U1/�C. NOI: Fort Collins, CO 80525 E-MAIL Tyler B. Allen ADDRESS: INSURER(S) AFFORDING COVERAGE _ NAIC N INSURER A: Great American EB,S Ins. Co. 37532 INSURED The Feet, Inc. INSURERS:Pinnacol Assurance Company 41190 Velocity Boys, Inc. 622 Sherry Drive INSURER C:AGCS Marine Insurance Co. 22837 Fort Collins, CO 80524 INSURER D: Praetorlan Insurance Co. 37257 INSURER E: Philadelphia IndemnityIns Co _ 18058_ 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 06DDL SUER POLICY NUMBER MMPOLICY DD/YYYY MPOLICY YY LIMITS D m GENERAL LIABILrrY EACH OCCURRENCE $ 1,000,00 D X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE Fx-� OCCUR PICC00004133 08/15/14 08/15/15 PREMISES Ea oiolamence $ 100,00 MED EXP (Any we person) $ 10,0001 PERSONAL a ADV INJURY $ 1,000,00 _ GENERAL AGGREGATE $ 2,000,00 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2,000,00 POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,00 X BODILY INJURY (Per person) $ D ANY AUTO ICC00004133 08/15114 08/15115 ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ _ $ UMBRELLA LIAR J( OCCUR EACH OCCURRENCE $ 2,000,00( X AGGREGATE A EXCESS LIAR CLAIMS4AADE 33306050 W15114 08/15115 $ 2,000,00 DEC RETENTION$ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN17-1 OFFICERIMEMBER EXCLUDED? (Mandatory lnNH) NIA 3534074 07/01/14 07/01/15 X WCSTATU- TH- E.L.EACH ACCIDENT - - $ 1,000,00 - $ 1,000,00 E.L. DtSFASE-EA EMPLOYE If yes describe under DESCRIPTION OF OPERATIONS below $ 1,000,00 E.L. DISEASE -POLICY LIMIT E Empl Dish PHSD945385 05/28/14 05/28115 Limit 250,000 C Trans/Cargo MZ198470793 02/15/15 02115/16 Limit 100,00 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Aswh ACORD 101, Additional Remarks Schedule, If more space is required) The City of Fort Collins is included as an additional insured per conditions and forma shown on page 2. CITYDIV City of Fort Collins Purchasing Division Attn: Jim Hume PO Box 580 Fort Collins, CO 80522-0580 \�SLICOl �lrrlS\aPIC 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 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD NOTEPAD FEET P�2 V INSUREDS NAPE The Feet, Inc. OP ID::JD DArE 02/09H5 p f required by written contract, the following endorsements apply on a lanket basis: ral Liability: 0371 (08/09) General Liability Broadening Endorsement including Additional Insured 04 (05/09) Waiver of Transfer of Rights or Recovery Against Others To US Liability: -B (06/00) Additional Insured Endorsement Compensation: 59b Blanket Waiver of Subrogation