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HomeMy WebLinkAboutFRONT RANGE INSTITUTE OF SAFTEY (MARK ROSOFF) - INSURANCE CERTIFICATEFRINS-1 OP ID: P5 ACORO' CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)12/11/2015 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 CONTACT NAME: House Account _ Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 A/CNNo EXt :970-482-7747 AIC No): 970-484-4165 Fort Collins, CO 80525 E-MAIL House Account ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC A INSURER A: Scottsdale Insurance Company 41297 INSURED Front Range Institute of INSURER B: Travelers Indemnity Company 25658 Safety, Mark Rosoff dba: 1437 Summitview Drive INSURERC: Ft Collins, CO 80524 INSURERD: INSURER E : INSURER F : r^M/PAA(:Fc r:FRTIFIr ATF NIIMRFR- 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 DDL UBk _ .POLICY EFF POLICY EXP LIMITS LTR W POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE X OCCUR X CPS2246554 06/27/2015 06/27/2016 DAMAGE TO RENTED- PREMISES Ea occurrence $ 100,00 1 MED EXP (Any one person) $ Exclude X Prof Liab $1Mil/$ PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY ❑ JE O LOC PRODUCTS - COMP/OP AGG $ Exclude $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED 1 RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN INUB9686C28A16 01/25/2016 01/25/2017 STATUTE ER E.L. EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) N f A E.L. DISEASE - EA EMPLOYE $ 100,00 E.L. DISEASE - POLICY LIMIT $ 500,00 If yes, aescnbe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Instruction in First Aid & CPR - City of Fort Collins is included as Additional Insured on the General Liability as respects the operations of the named insured per form CG2010 4-13 LAIN CITYF10 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 413 S. Bryan Ave. Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE House Account ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD