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517670 HOMEWARD ALLIANCE - INSURANCE CERTIFICATE
ACORO0 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/ 3/5/2019Y) 019 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 NAME: Cassi.e Talbot Professional Risk LLC AHr Ext: (970)356-8030 FAX No: I970)356-8032 E-MAIL cassie.talbot@proriskllc.com ADDRESS 8213 W.20th St INSURER(S) AFFORDING COVERAGE NAIC # _ INSURER A: Philadelphia Insurance Co 18058 Greeley CO 80634 INSURED INSURER B : Technology Insurance Company INSURER C: Homeward Alliance, Inc. INSURER D : PO BOX 873 INSURER E INSURERF: Fort Collins CO 80522-0873 COVERAGES CERTIFICATE NUMBER:19-20 All REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LIS I ED BELOW HAVE BEEN ISSUED f0 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 A L INSD SUER WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYV LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE rx-1 OCCUR PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 X PHPK1937258 3/8/2019 3/8/2020 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 PqPOLICY 4 LOC PRODUCTS - COMP/OP AGG $ 3,000,000 Professional Liability $ 3,000,000 OTHER. AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS $ UMBRELLA LIARi OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAR CLAIMS -MADE DED I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑N/A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) TWC3784531 3/1/2019 3/1/2020 X PE T - STATUTE ER E. L, EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 If yes, desc^be under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins, its officers, agents, employees and volunteers are additionally insured as it relates to the Mission of Hope Walk which will be held on December 8, 2018, per written contract. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Risk Management PO Box 580 Fort Collins, CO 80522 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 onne Perez/DP����Q� ACORD 25 (2014/01) INS025 (201401) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD