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129790 THE FEET INC - INSURANCE CERTIFICATE (13)
FEET-01 OP ID: JD ACORO' DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 015/28/2015 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 CONTNAME: Tyler B. Allen _ Brown & Brown Inc PHONE 970-482-7747 FAX 4532 Boardwalk Dr, Suite 200 A/C No Ezt : A/C No : 970-484-4165 Fort Collins, CO 80525 E-MAIL tallen/�bbcolorado.com Tyler B. Allen ADDRESS: tallen@bbcolorado.com AFFORDING COVERAGE NAIC A INSURER A: Philadelphia Indemnity Ins Co 18058 INSURED The Feet, Inc. INSURER B: Pinnacol Assurance Company 41190 Velocity Boys, Inc. INSURER C : AGCS Marine Insurance Co. 22837 3825 E Mulberry St., Unit 2A Fort Collins, CO 80524 INSURER D: Praetorian Insurance Co. 37257 INSURER E: Great American E&S Ins. Co. 37532 INSURER F : rOVFRAGFS CERTIFICATE NUMBER: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 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 TYPE OF INSURANCE A L U POLICY EFF POLICY EXP LIMITS LTR I POLICY NUMBER MM/DD/YYYY MMIDDIYYYY D X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE Lx J OCCUR PICC00004133 08/15/2014 08/15/2015 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 GEN'L PRO- RO- ❑ PRO-ECT LOC PRODUCTS -COMP/OP AGG $ 2,000,00 $ OTHER: AUTOMOBILE LIABILITY CMBINED SINGLE LIMIT EOa accident $ 1,000,000 BODILY INJURY (Per person) D X ANY AUTO PICC00004133 08/15/2014 08/15/2015 $ BODILY INJURY (Per accident) $ $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 E X EXCESS LIAB CLAIMS -MADE 3534074 08/15/2014 08115/2015 DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE a OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A _ 3534074 07/01/2014 07/01/2015 X STATUTE ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYEE $ 1,000,00 E.L. DISEASE -POLICY LIMIT $ 1,000,000 If yes, describe under DESCRIFTIGN OF OPERATIONS below A Empl Dishonesty PHSD1035364 05/28/2015 05/28/2016 Limit 250,00 C Trans/Cargo MZ198470793 02/15/2015 02/15/2016 Limit 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The certificate holder is included as additional insured per conditions and forms shown on page 2. !`C'oTIFIr ATF li 111=0 rANrFI I ATIr)N POUDRIV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Poudre River Library District 215 N. Mason AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 Q 4,_ v3wjj,� © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD FEET-01 PAGE 2 NOTEPAD INSURED'SNAME The Feet, Inc. OP ID: JD Date 05/28/2015 If required by written contract, the following endorsements apply on a blanket basis: eneral Liability: BCG0371 (08/09) General Liability Broadening Endorsement including Additional Insured G2404 (05/09) Waiver of Transfer of Rights or Recovery Against Others To US uto Liability: DDLINS-B (06/00) Additional Insured Endorsement orkers Compensation: 59b Blanket Waiver of Subrogation