HomeMy WebLinkAbout130574 LARIMER COUNTY CHILD ADVOCACY CENTER INC - INSURANCE CERTIFICATE (3)ACORD CERTIFICATE OF LIABILITY INSURANCE
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DATE(MM/DD/YYYYI
January 29, 201
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:
51601 / Ramsgate Insurance Inc
PHONE
FAX
250 East Park Avenue
(A/C No, Ext):
(A/C No):
E-MAIL
Lake Wales, FL 33853
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
j
INSURED
INSURER A: MARKEL INSURANCE COMPANY
313970
INSURER B:
Larimer County Child Advocacy Center, Inc.
INSURER C:
5529 S Timberline Road
Fort Collins, CO 80528
INSURER D:
INSURER E:
L
INSURER F:
COVERAGES 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
ADDL
SUBR
POLICY EFF
POLICY EXP
LTR
TYPE OF INSURANCE
INSR
WVD'
POLICY NUMBER
MM/DD/YYYY
(MM/DD/YYYY)
LIMITS
A
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES (Ea occurrence)
$ 100,000
® COMMERCIAL GENERAL LIABILITY
L� ❑ CLAIMS -MADE ® OCCUR
❑
®
❑
8502SS390021-3
03-09-2016
03-09-2017
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
{
I
❑
GENERAL AGGREGATE
$ 3,000,000
GEML AGGREGATE PIM01T APPLIES PER:
❑ POLICY ❑ JECT ❑ LOC
PRODUCTS - COMP/OP AGG
$ 1,000,0001
S
AUTOMOBILE LIABILITY
❑ ANY AUTO
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY (Per person)
S
❑ ALL OWNED ❑ SCHEDULED
AUTOS AUTOS
❑ HIRED AUTOS ❑ NON -OWNED
AUTOS
El
S
BODILY INJURY (Per accident)
(Per accident)
PROPERTY DAMAGEF-1
S
UMBRELLA LIAB OCCUR
❑
❑
EACH OCCURRENCE
$
EXCESS LIAB CLAIMS -MADE
U
AGGREGATE
$
❑ DED ❑ RETENTION S
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y/N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
N/A
❑
❑ WC STATU- ❑ OTH-
TORY LIMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory in NH)
It yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
I
I
_
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
I Certificate holder is included as additional insured for operations conducted by the named insured.
i
L
CERTIFICATE HOLDER
Fort Collins Police Department
2221 South Timberline Road
Fort Collins, CO 80528
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY
PROVISIONS.
AUTHORIZED REPRESENTATIVE
Bruce A. Kay
(c) 1988-2010
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
BWAI
10
RATION. rights reserved.