HomeMy WebLinkAboutLARIMER COUNTY COLORADO - INSURANCE CERTIFICATE (2)ACORv CERTIFICATE OF LIABILITY INSURANCE
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DATE(MMIDDNYYY)
6/412020
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFVELY OR ?ORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE'. HOLDER. THIS
DOES NOT EXTEND OR ALTER THE COVERAGEAFFORDEDY THE POLICIES
BELOW. THIS CERTIFICATE OATE
F INSURANCE DOES NOT CONSTITUTE _P,,
CONTRAC BETWEEN ISSUING SUE ER S),. AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL- INSURED, the policy(ies) 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 endorsemenL A statement on
this_certificato does not confer rt hts.to the certificate ' older. in lieu of such: endorsement s .. .. _ .. _.-
PRODUCER
Arthur J. Gallagher Risk Management Services, Inc.
6300 South Syracuse Way, Suite 700
Centennial CO 80111
NAME: Nathan Kathol
PHONE 303-889-2574
DURESS: Nathan—Kathol@ajg.com
'.INSURE AFFORDING COVERAGE.
NAIL a
INSURER A: Argonaut Insurance Coman
19801
INSURED
Larimer County, Colorado
200 W. Oak Street
INSURERB :.
INsureri0.
INSURERD.:
Suite 4000
Fort Collins CO 80577
INSURER E:.
.INSURER F :.
L.7JVtHAUt:S .GERTIFIGATE NUMBER' 171QRRADQ9 RFVIQIr1N NI IMRFR.
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,CONOITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE EXCLUSIONS AND MAYBE IS OF SUCH POLICIES. LIMITS SH LIED OR MAY PERTAIN, THE
INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL`THE TERMS,
OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTFi
TYPE OFINSURANCE .
DOL
1
U R
yyyp
POUCYNUMBER
POLICY EFF
MMIDONY
WWIV EXP
Q/YY
-
WrHtS'
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
Y
290201905
5/15/2020
5/15/2621 -
EACH OCCURRENCE.
$1.000,000
PREMISES Ea occurrence
$
MED EXP (An oneperson).
$
PERSONAL &ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
%( POLICY JrRO PRO- ❑ LOC
GENERALAGGREGATE
$1,000,000
PRODUCTS - COMP/OP. AGG..
$.
I
$
OTHER:
A
AUTOMOEILELIABiuTY
ANY.AUTO
290201905
511512020
5115/2021
E BINEDSINGLE LIMt
Egg
$1,000.000
'X
BODILYINJURY(Per person)
�$
OWNED SCHEDULED
HIRED AUTOS ONLY AUTOS
NON
AUTOS ONLY AUTOS ONLY
80DCLV INJURY (Peraatident)
$
-
Per weldenDAMAGE
$
I
UMBgcr r e LIAB
OCCUR
EACHOCCURRENCE
$
AGGREGATES
.$ ..
Excess Lt"
CLAIMS -MADE
I
DED I I RETENTION $
-. _. . _ _.... - .
$
- . _
... . _
WORKERS COMPENSATION
AND EMPLOYERS'LIABILrtt YIN,.R
.
ANYPROPRIETOR/PARTNERIEXECUTIVE
OFFICERANEMBEREXCLUDED?
N/A
. STATUTE ER -
E.L. EACH ACCIDENT
-
$
E.L. DISEASE -.EA EMPLOYEE
$.
(Myyandatory In NN)
cribe under
DESCRIPTIONOFOPERATIONS below,
-
EL. DISEASE - POLICY LIMIT
$ -
I
DESCRIPnoN OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, AddlOonal Remarks Schedule, may be attached If more space 19 required) -
The City of Fort Collins is Additional Insured as respects General Liability policy, pursuant to and subject to the policy's terms, definitions, conditions and
exclusions.
RE: Revocable Permit for Access on City property, Front Range Tral,project on Flores Del Sol Natural Area
Dates: March 1, 2017 through Febr6ary.28, 2018
Location: Exhibit A - The N1l2 of the BE 1/4 of Section 19. Townshi( 6 North, Range 68 West of the 6th P.M., County of Larimer, State of Colorado. Execpting
therefrom that part conveyed to the Board of County Commissioners In Deed of Dedication recorded May 4, 1994 at Reception No. 94039129, (Vacant land, no
street address assigned.) I
City of Fort Collins, Risk Management
PO BGx.580
Fort Collins CO 80522-0580
USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL_ BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
ACORD 25 (2016103)
The ACORD name
01988-2015 AC
logo are registered marks of ACORD
All rights reserved.
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