HomeMy WebLinkAbout102622 POUDRE SCHOOL DISTRICT R-1 - INSURANCE CERTIFICATECOLORADO SCHOOL DISTRICTS SELF INSURANCE POOL
CERTIFICATE OF COVERAGE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON
THE
07/01/2019
CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND
OR
ALTER THE COVERAGE AFFORDED BY THE
POLICY BELOW. THIS CERTIFICATE OF INSURANCE DOES
NOT
CONSTITUTE A CONTRACT BETWEEN
THE ISSUING INSURER, AUTHORIZED REPRESENTATIVE
THE
CERTIFICATE HOLDER.
MEMBER:
POUDRE SCHOOL DISTRICT R-1
Colorado School Districts Self
ATTN:
Kristin Bennett
Insurance Pool, 6857 South Spruce St.
ADDRESS:
2407 LA PORTE AVENUE
Centennial, Colorado 80112
CITY, STATE ZIP:
FORT COLLINS, CO 80521 2297
(303) 722-2600
(303)722-7888 Fax
POLICY NUMBER:
6216-19-00215
POLICY PERIOD:
07/01/2019 to 07/01/2020
THIS IS TO CERTIFY THAT THE POLICY OF COVERAGE LISTED BELOW HAS BEEN ISSUED TO THE MEMBER 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 COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS, DEFINITIONS AND CONDITIONS OF SAID POLICY. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF COVERAGE
LIMITS/DEDUCTIBLES
SCHOOL ENTITY LIABILITY
Occurrence Form
EACH OCCURRENCE, SCHOOL LEADERS WRONGFUL ACT
$10,000,000
& EMPLOYMENT WRONGFUL ACT
ANNUAL AGGREGATE LIMIT
$15,000,000
MEDICAL EXPENSE (PER PERSON/PER ACCIDENT)
$1,000/$10,000
SCHOOL AUTO
Any Auto, Hired and Non -Owned
LIMIT PER ACCIDENT
$5,000,000
Medical Payments
LIMIT PER ACCIDENT/PER PERSON
$5,000
Auto Physical Damage Coverage
AUTO PHYSICAL DAMAGE DEDUCTIBLE
$10,000
PROPERTY
Special Form
BUILDING/BUSINESS PERSONAL PROPERTY LIMIT
$890,123,753
PROPERTY DAMAGE TO PREMISES RENTED TO YOU
$500,000
DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES SPECIAL ITEMS
Certificate Holder is included as an
Additional Insured on the Member's School Entity Liability Coverage &
Auto Liability Coverage
for "bodily injury", "personal injury"
or "property damage" caused by the Member's negligence if required
by written contract or
agreement subject to the policy terms
and conditions with respects to any function or activity held on
the Certificate Holder's
premises during the policy period.
CANCELLATION: SHOULD THE ABOVE DESCRIBED POLICY BE
CERTIFICATE HOLDER:
CANCELLED BEFORE THE EXPIRATION
DATE, WE WILL ENDEAVOR
TO MAIL 30 DAYS WRITTEN NOTICE
TO THE CERTIFICATE HOLDER
NAMED TO THE LEFT, BUT FAILURE
TO MAIL SUCH NOTICE SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY IQND UPON THE
COMPANY, ITS AGENTS OR REPRESENTATIVES.
City of Fort Collins Risk Management Department
AUTHORIZED REPRESENTATIVE
P O Box 580
Fort Collins, CO 80521