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HomeMy WebLinkAboutNORTH WELD COUNTY WATER DISTRICT - INSURANCE CERTIFICATE (4)CERTIFICATE OF COVERAGE Certificate #: 4174 Administrator THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN Colorado Special Districts Property and Liability Pool THOSE PROVIDED IN THE COVERAGE DOCUMENT. THIS CERTIFICATE PO Box 1539 DOES NOTAMEND, EXTEND ORALTERTHE COVERAGE AFFORDED BY THE COVERAGE DOCUMENTS LISTED HEREIN. Portland, OR 97207-1539 'NAMED COMPANIES AFFORDING COVERAGE MEMBER COMPANYA Colorado Special Districts Property and Liability Pool North Weld County Water District COMPANY B General Reinsurance Corporation PO Box 56 - — — - — - — Lucerne, CO 806460056 COMPANY C Colorado Special Districts Property and Liability Pool COMPANY D COVERAGES — This is to certify that coverage documents listed herein have been issued to the Named Member herein for the Coverage period indicated. Nothwithstanding any requirement, term or condition of any contract or other document with respect to which the certificate may be issued or may pertain, the coverage afforded by the coverage documents listed herein is subject to all the terms, conditions and exclusions of such coverage documents. CO Type of Coverage Coverage # Effective Date Expiration Date Limits LTR i General Liability A, B X Commercial General Liability 29C54082-409 1/1/2016 1/1/2017 General Aggregate Unlimited $1,000,000 ' Except that for claims, occurrences or suits to which the Each Occurrence ` monetary limits of the Colorado Governmental Immunity Act, X Public Officials Liability C.R.S. § 24-10-101, et. seq., as amended, apply, there shall be a further sublimit of (a) $350,000 for an injury to any one person X Employment Practices in any single occurrence; and (b) $990,000 for an injury to two or more persons in any single occurrence; but in the event of an X Occurrence injury to two or more persons in any single occurrence, the sublimit shall not exceed $350,000 for each injured person. A Automobile Liability 29C54082-409 1/1/2016 1/1/2017 Each Occurrence • $1,000,000 B X Scheduled Autos X Hired Autos X Non -Owned Autos Auto Physical Damage Scheduled Autos Hired Autos B Excess Liability 29C54082-409 1/1/2016 1/1/2017 General Aggregate Unlimited Each Occurrence $4,000,000 AI Other Than Umbrella Form I Property i� DESCRIPTION: Certificate Holder is an additional covered Member for those coverages noted hereunder but only with respect to those liabilities that are covered by the Pool's coverage document for the Member District arising from the easement agreement and subject to the provisions and limitations contained in C.R.S. 24-10-101. The Pool will limit any amounts to the monetary limits and sublimits of the Colorado Governmental Immunity Act, C.R.S. 24-10- 101 et. Seq., as amended, would apply to the Covered Member. CERTIFICATE HOLDER CANCELLATION: 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. PO Box 580 Ft. Collins, CO 80522 Date: 12/28/2015 By: Joseph E. DePaepe1. // ,� ) fl �1_-7 -, -L -v-v 01—