HomeMy WebLinkAboutLARIMER COUNTY COLORADO - INSURANCE CERTIFICATEAC1J'Rbr CERTIFICATE OF LIABILITY INSURANCE DATE(MM°°YYYY)
6/412020
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: It the certificate holder Is an ADDITIONALI INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or 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 ouch endorsement(s).
PRODUCER NAME: Nathan Kathol
ArthurJ. Gallagher Risk Management Services, Inc. PHONE 303-869-254&_ ..._... : _ I ac No:220 200-5127
6300 South Syracuse Way, Suite 700 (Auc No E-MAIL
Centennial CO 80111 v RESB: Nathan Kathol a' .com
LarimerCounty, Colorado
200 W. Oak Street
Suite 4000
Fort Collins CO 80522
f�AVCG A!]CC /;COTICIr_ATC NI IRACIeD- 4odlljnn7Q QCNICInN NIIJUIRFR•
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
EXCLUSIONS AND CONDITIONS OPSUCH POLICIES. LIMITS SHOWN
AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO.ALL THE TERMS,
MAY HAVE BEEN`REDUCED BY PAID CLAIMS.
INSR
LTR
.. .. :.
TYPE OF INSURANCE
DL
a
- :.i
:. . .
POLICY NUMBER
POLICY EFF
MMIDDNY.Y
POLICY pry
D/YYY
L169TB
A
X
I COMMERCIAL GENERAL LIABILITY
Y
2902019M
5115d02O
51152021
EACHOCCURRENCE ..
$1,000,000
CLAW -MADE I I OCCUR
DAMAGE TO RENTED
PREMISESS Ea'occurrence
$
MED EXP(Any .one person)
$
PERSONAL &ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
X POLICY ❑. JECT LOC
PRODUCTS -COMPIORAGG
$
$
OTHER:
A
AUTOMOBILELIABILITY
290201905
5115/2020
5/152021
`E pN DSINGLELIMIr
$Included
eoDILY INJURY (Per person)
$ In
X7 ANY AUTO
.SCHEDULED
AUTOS
BODILY INJURY (Per accident)
$Above,
Per acEORdent AMAGE
$
HIRED . i
AUTOS ONLY
nA
$
OCCUR
EACHOCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS•MADE
DED. .RETENTION$ .
I 5.. ...
. ...
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNERIEXECUTIVE ❑
OFFICERlMEMBEREXCLUDED?
(MandatoryMNH)
NIA
SP4060404
5JI52019
5/15202,
X STATUTH-
TE :I,
E.L. EACH ACCIDENT
$1,000,000
E.L. DISEASE - EA.EMPLOYEE
-
$1,000,000
E.L. DISEASE- POLICY. LIMIT
$ i,000,000
Il yos, doscnbe under
DESCRIPTION OF OPERATIONS below
A.
Public Officials Wrongful Act
Includs Prolesssional Liability
290201905
5/152020
5/152021
Ewh Occurrence
Aggregate
$1,000,000
$1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional
Renredra Schedule, may, be attached If more apace:19 mclubad).
RE: Training classes for CDPHE Grant
Certificate. Holder is an Additional Insured as respects General
Liability and Auto Liability policies, pursuant to and subject to the policy's terms, definitions,
conditions and exclusions.
^enT1M1^An-e uAl nen I OAMccI.I ATnm
SHOULD ANY OF THE ABOVEDESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins, Risk Management
ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
pum Rlzeo REPRESENTATIVE
g
Fort Collins CO 80522 0580
USA
f9) 1y89-ZU15 AC0HU GUKF VHAIIUN. All ngnts reserveo.
ACORD 25 (2016(03) The ACORD n e and logo are; registered marks of ACORD,
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