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HomeMy WebLinkAbout129790 THE FEET INC - INSURANCE CERTIFICATE (15)FEET-01 OP ID: JD ACORO' DD/YYYY) DATE (MMl �� CERTIFICATE OF LIABILITY INSURANCE DATE(MMI2016 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. It 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 CONTANAME: Jody Wagner Brown & Brown Inc - 4532 Boardwalk Dr, Suite 200 A/CNNo El :970-482-7747 FAX No): 970-484-4165 Fort Collins, CO 80525 E-MAIL Tyler B. Allen ADDRESS: Iwa ner bbcolorado.com 9 INSURED Velocity Boys, Inc. 3825 E Mulberry St., Unit 2A Fort Collins, CO 80524 INSURERS) AFFORDING COVERAGE NAI INSURER A: Philadelphia Indemnity Ins Co 18058 INSURER B: AMCO Insurance Company 19100 INSURER C : Pinnacol Assurance Company 41190 INSURER D :AGCS Marine Insurance Co. 22837 INSURER E: Depositors Insurance Company 42587 COVFRARFS rFRTIFIr'ATF NIIMRFR• REVISION NIIMRFR- 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. LTR TYPE OF INSURANCE kDDL LBR� POLICY NUMBER MPOLICY I IDYY MMIDD/YYYY LIMITS B X I COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE X 1 OCCUR ACPGLA03007216988 08/15/2015 08115/2016 DAMAGE TO RENTED PREMISES Ea occurrence) $ 100,00 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 1,000,00 lGEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO LOC JECT PRODUCTS - COMP/OP AGG $ 2,000,00 _ $ OTHER: AUTOMOBILE LIABILITY COEaMBINED accidentSINGLE LIMIT $ 1,000,00 BODILY INJURY (Per person) $ E X ANY AUTO ACPBAPD3007216988 08/15/2015 08/15/2016 _- ALL OWNED SCHEDULED _ AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS L BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 5,000,00 AGGREGATE $ 5,000,00 B EXCESS LIAB CLAIMS -MADE ACPCAA3007216988 08/15/2015 08/15/2016 DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y� OFFICER/MEMBER EXCLUDED? (Mandatory In NH) NIA 3534074 07/01/2015 07101/2016 PE H- X STATUTE I ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,OOU A Empl Dishonesty _ PHSD1035364 _ 05/28/2015 05/28/2016 Limit 250,000 D Tran/Cargo SML98470793 02/15/2016 02/15/2017 Limit 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins is included as an additional insured per conditions and forms shown on page 2. rFRTIFIrATF 141"M r1FR r'ANrr-1 I ATION CITYDIV 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. Purchasing Division AUTHORIZED REPRESENTATIVE Attn: Jim Hume PO Box 580 Fort Collins, CO 80522-0580 �l © 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 02/05/2016 If required by written contract, the following endorsements apply on a blanket basis: General Liability: CG7212 General Liability Broadening Endorsement including Additional Insured CG7212 Blanket Waiver of Subrogation Auto Liability: AC0101A Blanket Additional Insured Endorsement and Waiver of Subrogation Workers Compensation: 359b Blanket Waiver of Subrogation