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HomeMy WebLinkAboutCOLORADO STATE UNIVERSITY OFFICE OF RISK MANAGEMEN - INSURANCE CERTIFICATE (2)ACC CERTIFICATE OF LIABILITY INSURANCE 03/1 /20Y1'YYI �/ 03/il/a01s 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(les) must be endorsed. H 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 1-303-534-4567 CONTACT ITLA, Inc. - Colorado Division NAME: PHONE iFAX IAIC. No Eb1: IA/C. No): 1705 17th Street EJIAIL ADOREBB• denDam41msaorD.000 suite 100 )Mover, CO 80202 INSURER(S) AFFORDING COVERAGE NAILS _ INBURERA: STARR IND A LIAB CO 38318 INSURED INSURER B: SAPETf NATL CAS CORP 13105 Colorado State University Office of Risk Management 4 Insurance INSURER C: TRAVELERS PROP CAS CO OF AMIR 25674 141 Gen•1 Sery Bldg -Campus Del 6002 INSURER 0:_ _ Fort Collins, CO 80523-6021 INSURER E: _ INSURER F : CAVFRAGFB CERTIFICATE MIIYRFR• 4323906q Ri:vm AN MIIIUIRFR- 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. INM Im TYPE OF INSURANCEJma POLICY NUMBER POLICY EFF PM/DDY YYY Lam A GENERAL LL48U Y 1000005229 07/01/1 07/01/15 EACH OCCURRENCE $ 10, 000, 000 Z COMMERCIAL GENERAL LIABILITY AMAGET RENTED PREMISES fEa ocauhronolINCLUDED CLAIMS -MADE FXI OCCUR MED EXP one Person $ EXCLUDED PERSONAL S ADV INJURY $INCLUDED E SIR:$500,000 Z Incl. NOMt Liq Liab. GENERAL AGGREGATE $0 GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG 510,000.000 $ POLICY PRO- LOC A AUTOMOBILE LuumnlY 1000005219 07/01/1 07/01/15 COMBINED SINGLE LIMIT e socided 10 000 000 BODILY INJURY Per person) $ E ANY AUTO ALL OWNED SCHE DU AUTOS _ AUTOS BODILY INJURY (Per arcdwil) $ PROPERTY DAMAGE P $ X HIRED AUTOS X NONDWNED AUTOS $ E SIR:$500,0 0 UMBRELLA LLAB OCCUR EACH OCCURRENCE It AGGREGATE $ EXCESS LUB_ CLAIMS -MADE $ DIED RETENTION B C WORKERS COMPENSATION AND EMPLOYERS' LIABILtrY ANY PROPRIETOWPARTNER/EXECUTIVE YIN OFFICER)MEMBER EXCLUDED? F1_T1 (Mandatory In NH) MIA SPA051108 - CO ONLY UB607ON92A14 - AOS 08/01/1 07/01/1 08/01/15 07/01/15 E WCSTATU- OTH- E.L. EACH ACCIDENT $ 1.000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 II yes, deso" under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 110001000 RRE TrORS COLuPF.NSATION AND SPA09rluff- Co ONLY EMPLOYERS' LIABILITY *Retention: $500,000 �I(AOS=A11 Other States) DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ANsch ACORD 11H. Additional Remarks Schedule, 8 more space Is required) RE: -Leave it Behind Tent Sale- on June 19-219t. The City of Fort Collins, its officers, agents, employees and volunteers are included as Additional Insureds on the General and Automobile Liability Policies if required by written contract or agreement subject to the policy terms and conditions. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE :ity of Port Collins - Risk Management THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 AUTNORRED REPRESENTATIVE Port Collins, CO 80522-0580 USA 111 df ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD eadie55 43238069