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HomeMy WebLinkAboutFOOTHILLS GATEWAY INC - INSURANCE CERTIFICATE (6)AC oRo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) 6/13/2019 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 Flood and Peterson PO Box 578 Greeley CO 80632 CONTACT NAME: Kelly Beauvais, CIC, CISR aIC NN (970)356-0123 NC No: (970)330-1867 E-MAIL keeauvais@floodpeterson.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:Philadelphia Indemnity Insurance 18058 INSURED Foothills Gateway, Inc. 301 West Skyway Drive Fort Collins CO 80525 INSURERB:Pinnacol Assurance 41190 INSURERC: INSURER D: INSURER E : INSURER F: rnVFRArFC CFRTIFICATF NIIMRFR•Master 19-20 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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 ADDL UBR POLICY NUMBER EFF MM DDPOLICYIYYYY Y EXP MM/DDIYYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE F EOCCUR DAMAGE TO RENTED PREMISES Ea occurrence) $ 100,000 MED EXP (Any one person) $ 10,000 PHPK1995330 7/1/2019 7/1/2020 PERSONAL & ADV INJURY $ 1,000,000 GEN'LAGGREGATELIMIT APPLIES PER. GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OPAGG $ 3,000,000 X PRO- POLICY ❑ PRO LOC Employee Benefits $ 1,000,000 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A X ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED x HIREDAUTOS x AUTOS PHPK1995330 7/1/2019 7/1/2020 BODILY INJURY (Per accident) $ PROPERTY eOPPE R�TY DAMAGE P $ Uninsured motorist combined single $ 1,000,000 X UMBRELLA LAB x OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 A EXCESS LIAB CLAIMS -MADE DIED I X I RETENTION $ 10,000 $ PHUB680116 7/1/2019 7/1/2020 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/FXECUTIVE x PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 B OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A 703552 7/1/2019 7/1/2020 I E.L. DISEASE - POLICY LIMIT $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below A Cyber Liability PHPK1995330 7/1/2019 7/1/2020 Limit $2,000,000 Agg A Professional Liability PHPK1995330 7/1/2019 7/1/2020 Limit $3,000,000 Agg DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Flying Pig 5K - April 08, 2018 - Spring Canyon Park The City of Fort Collins, its officers, agents, employees and volunteers are additionally insured as it relates to the Annual Flying Pig 5K, which will be held on April 08, 2018- CERTIFICATE HOLDER CANCELLATION lmurray@fcgov.com City of Fort Collins - Risk Management PO Box 580 Fort Collins, CO 80522-0000 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 Beauvais, CIC, CISR � &--14' © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD INS025 (201401)