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HomeMy WebLinkAbout186415 TURNING POINT CENTER FOR YOUTH & FAMILY DEV - INSURANCE CERTIFICATECERTI
OF LIABILITY INSURANCE
DATE (MMIDO/YYYY)
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CC
REPRESENTATIVEOR PRODUCER, AND THE CERTIFICATE
r AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THU
EXTEND OR ALTER THE COVERAGE' AFFORDED BY THE POLICIES
E'A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
IMPORTANT:. It the certificate holder Is an ADDITIONAL I1113IURE0, the pOUCy(IeS) must. have ADDITIONAL IN3UtiED provisions Or he endorsed.
If SUBROGATION IS WAIVED, subject to the terms and condklons 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).
Flood and Peterson
PO Box 578
Greeley COS 80632 INSURER A: Philadelphia Indemnity Insurance 18058
INSURED _ - INSURERS: PinrlaCDIASSurdh e.
Turning Point Center For Youth & INSURERC: Lloyds of London
Family Development, Inc. INSURERD:
3030 S. College Ste. 200 INSURER E :
Fort Collins CO 80525 rusudco c
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
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWNIMAY
BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
HAVE BEEN REDUCED BY PAID CLAIMS.
LTR
TYPE OF INSURANCE
POLICY
NUMBER
MMID
M
LIMITS
COMMERCIAL GENERAL LOASIR. ITY
EACH OCCURRENCE
S 1,000,000
CLAIMS -MADE ® OCCUR
PREMISES Ea occurrence
S 1,000,000
MED EXP (Any me person)
S 20.000
PERSONAL &ADV INJURY
$ 1,000,000
A
Y
PHPFC?057725
11/01/2019
10/01/2020
GEN'LAGGREGATE LIMIT APPLIES PER:
X POLICY ❑ JECTT 7 LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS-COMPIOPAGG
$ 2,000,0.00
Liquor Liability
$ 1,000,000
OTHER:
AUTOMOBILE
LIABILITY
COM tlNaED SINGLE LIMIT
$ 1,000,000
BODILY INJURY (Par wram)
$
ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
PHPFC2057725
11/61/2019
10/0112020
BODILY INJURY (Per accidere)
S
PROPERTY DAMAGE
Per accident
_
HIRED - NON -OWNED
AUTOS ONLY AUTOS ONLY
Uninsured motorist Bl-
$ 1,000,000
UMBRELA I"
OCCUR
EACH OCCURRENCE
y 3,000,000
AGGREGATE
y 3,000,000
A
EXCESSUAB
CLAIMS -MADE
PHUB699505
11/012019
10/01/2020
DIED RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERMIEMBER EXCLUDED? 7
(Mandatory in NH)E.L..
NIA
4044187
10/01/2019
10/01_/2020
PER
STATUTE
OTH-
ER
E.L. EACH ACCIDENT
S 1,000,000
DISEASE - EA EMPLOYEE
$ 1,000,000
I ves, describe under
DESCRIPTION OF OPERATIONS balm
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
A
Professional Liability
PHPK201
25
11/012019
10/01/2020
Each Incident
Aggregate
1,000,000
3,000,000
bascammok OF OPERATIONS I LOCATIONS I VEHICLES IACONO 101, AdOitimal
Remarks Schedule, may be attached It mors space Is repuiredl
RE: Comhole Festival -Awesome Toss'Em, August 29, 2019
The City of Fort Collins, its officers, agents, employees and volunteers
are named as additional insured as it relates to the Awesome Toss'Em Comhole
Festival held on August29, 2018 for General Liability. Liquor Liability $1,000,OOO
Limit
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 13E CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins
ACCORDANCE WITH THE POLICY PROVISIONS:
Risk Management
AUTHORIZED REPRESENTATIVE
PO Box 580
Fort Collins C
80522-0580
'
01888-201 S ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD
ADDITIONAL COVERAGES
Ref # I
C
Description
Cyber Liability- Policy #EVO-PNY-472-248
Coverage Code
CYBER
Form No.
Edition Date
Limit 1
1,000,000
Limit 2
Limit 3
Deductible Amount
Deductible Type
Premium
Ref #
Description
Coverage Code
Form No TEdition
Date
Limit 1
Limit 2
Limit 3
Deductible Amount
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Premium
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Coverage CodTworem;
m No.
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