HomeMy WebLinkAbout174626 FORT COLLINS HABITAT FOR HUMANITY - INSURANCE CERTIFICATE (5)CERTIFICATE OF LIABILITY INSURANCE
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 INSURERS(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
ucr
Lockton Affinity, LLC
P.O. Box 873401
HONE
A/C No.Ext): 888-553-9002
AX
A/C, No):
-MAIL
%DDRESS:
Kansas City, MO 64187-3401
INSURER(S) AFFORDING COVERAGE
NAIL
NSURER-A: ACE Arrlerican Insurance Co.
22667
INSURED
Fort Collins Habitat for Humanity
4001 S Taft Hill Rd,
Fort Collins, CO 80526-2948
NSURER-B:
NSURER:
NSURER-D:
NSURER-E:
NSURER-F:
LUVCKAUCJ U- K11YIUAIY NIIMKYK[ RFVLCI"NI NIIMRi w.
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.
IN
SR
LT
R
TYPE OF INSURANCE
ADDL
INSR
5US
R
WD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY)
POLICY EXP
MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
OMMERCIAL GENERAL LIABILITY
XiLAIMS MADE X OCCUR
X
GL1064502-15
04/01/2015
04/01/2016
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO
PREMISES (EaENTED occumence
$1,000,000
MED EXP (Any onePerson)
$ 0
PERSONAL B ADV INJURY
$1,000,000
GENERAL AGGREGATE
$ 2,000,000
ENT AGGREGATE LIMIT APPLIES PER
X OLICY
PRODUCTS - COMP/OP AGG
$2,000,000
$
AUTOMOBILE LIABILITY
NY AUTO
LL OWNED SCHEDULED
UTOS AUTOS
NON -OWNED
IRED AUTOS AUTOS
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY Per Person
$
BODILY INJURY Per accident
$
PROPERTY DAMAGE
Per accident
$
MBRELLA LIAR
XCESS LIAB
OCCUR
CLAIMS MADE
EACH OCCURRENCE
$
AGGREGATE
$
ED
RETENTION $
ORKERS COMPENSATION
ND EMPLOYERS' LIABILITY
.NY P_P.OPRIETOR/PARTNERIEXECUTIVE Y/N
C STATUU
DRY LIMITS
TH-
R
FFICER/MEMBER EXCLUDED?
E.L. EACH ACCIDEN I
$
MANDATORY IN NH)
f es, describe under
E.L. DISEASE - EA EMPLOYEE
$
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS
City of Fort Collins
P.O. Box 580, C_
Fort Collins, CO 80522
ACORD 25 (2010/05) The ACORD name and loqo are registered marks
1064502