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315931 BIG THOMPSON WATERSHED FORUM - INSURANCE CERTIFICATE (8)
,a►co oiz CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 12/19/2015 THIS CERTIFICATEIS 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 SUBROGATIONIS 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). PRODUGXR PAYCHEX INSURANCE AGENCY INC 210705 P: F: (888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: (nCC..NN..Ecp: FAX C.No): (888) 443-6112 ADDR EoIAIL s INSURER(S) AFFORDING COVERAGE NAIL& wsuRERA: Twin City Fire Ins Co INSURED BIG THOMPSON WATERSHED FORUM 800 S TAFT AVE LOVELAND CO 80537 INSURER B : INSURER C: INSURERD: INSURER E: INSURER F: r0VFRAr9FS CFRTIFICATF NUMBER: KtV151UN NUMBtK: 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 TPE OF L\SURANCE ADD SUB " WL7(,1NUMIIER POLICPEFF DAI POLICYEAP LINZS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one parson) $ PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE g PRODUCTS -COMPIOP AGO $ POLICY PRO- LOG JECT OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED BODILY INJURY (Per accident); AUTOS AUTOS PROPERTY DAMAGE (Per accident) 5 HIRED AUTOS NON -OWNED AUTOS UMBRELLA UAB OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS -MADE AGGREGATE DE RETENTION S R'ORSEBSCO.VPSA'SADOA' X PER OTH- STAME ER M'O ENPLOPEHSLIw66IlP ANY PROPRIETOWPARTNEWEXECUTIVEYIN E.L. EACH ACCIDENT $1 Q 0 , 000 A OFFICERIMEMBER EXCLUDED? (Mandatory in NH) ❑ N/A 76 WEG PE5980 Ol/Ol /2016 01/01/2017 E.L. DISEASE -EA EMPLOYEE 110 Q, QQQ If yes, describe under E.L. DISEASE -POUCY LIMIT e 5j Q Q 000 DESCRIPTION OF OPERATIONS below r DESCRIPTION OFOPFRATIONS ILOCATIONSI VEHILMRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. rGOThcH-ATA unh nF:0 CANCFI I ATIOIN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The City Of Fort Collins Y BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ` Fort Collins WTP 4316 TE AVE 7Q'2_' 80521 FORT COLLRINS, ©1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2014101)