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HomeMy WebLinkAbout109737 UNITED DAY CARE CENTER DBA TEACHING TREE - INSURANCE CERTIFICATE___1 UNITDAY-01 VMATHIASON
ACORD CERTIFICATE OF LIABILITY INSURANCE FDAT3/2/2 D/YYYY)
3/2/2016
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:
PFS Insurance Group PHONE 970 635-9400 FAX 970 635-9401
4848 Thompson Parkway Suite 200 A/c No Ext: ( ) — (A/C, No): ( )
Johnstown, CO 80534 E-MAIL
AnnRFSS. valeriem0mv0sinsurance.com
INSURED
United Day Care Center, Inc. dba Teaching Tree Early
Childhood Learning Center
dba Teaching Tree
424 Pine St, Suite 100
Fort Collins, CO 80524-2421
INSURER(S) AFFORDING COVERAGE I NAIC #
INSURER A: Hanover American Ins. Co. 136064
INSURER B : Pinnacoi Assurance Co 141190
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVERAGES CFRTIFICATF N(1MRFR- IZF=VIC1nN Ni IMRFR•
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.
I�TR TYPE OF INSURANCE POLICY EFF POLICY EXP
INSD WVD POLICY NUMBER MM/DD/YYYY MM DD/YYYY LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE rx] OCCUR
ZB4A16473902
12/01/2015
12/01/2016
EACH OCCURRENCE
$ 1,000,000
PREMISES (Ea occurrence)
$ 100,000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,00
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT 7 LOC
FIOTHER:
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
AUTOMOBILE
LIABILITY
SINGLE LIMIT
Ee accident)
$ 1,000,00
BODILY INJURY (Per person)
$
A
ANY AUTO
ZB4A16473902
12/01 /2015
12/01/2016
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY Per accident
( )
$
HIRED AUTOS X NON -OWNED
AUTOS
X
PROPERTY DAMAGE
Per accident
$
_
X
UMBRELLA LIAR
X
OCCUR
EACH OCCURRENCE
$ 1,000,000
AGGREGATE
$
A
EXCESS LIAB
CLAIMS -MADE
UH4A16476202
12/01/2015
12/01/2016
DIED I I RETENTION $
Aggregate
$ 1,000,000
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? �
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
N/A
4172048
04/01/2016
04/01/2017
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$ 100,00
E.L. DISEASE - EA EMPLOYE
$ 100,00
E.L. DISEASE - POLICY LIMIT
$ 500,00
A
Property
_
ZB4A16473902
12 O112015
12/01/2016
BPP 97,957
A
Crime (Includes Burg
ZB4A16473902
12/01/2015
12/01/2016
Died. 1,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability.
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
215 North Mason Street
Fort Collins, CO 80524
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 jREEPRESENTATIVE
q H 1
© 1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
UNITDAY-01 VMATHIASON
ACORO CERTIFICATE OF LIABILITY INSURANCE DATE 11130/2015Y)
11 /30/2015
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:
PFS Insurance Group PHONe — FAX
4848 Thompson Parkway Suite 200 (A/C, No, Exit): (970) 635-9400 (AtC, No): 1970) 635-9401
Johnstown, CO 80534 ADDRESS: valeriem@mypfsinsurance.com
INSURED
United Day Care Center, Inc. dba Teaching Tree Early
Childhood Learning Center
dba Teaching Tree
424 Pine St, Suite 100
Fort Collins, CO 80524-2421
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: Hanover American Ins. Co.
36064
INSURER B : Plnnacol Assurance Co
41190
INSURER C :
INSURER D :
INSURER E :
INSURER F :
COVFRAGFS CFRTIFICATF NIJMSFR! 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 ryPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DDNYYY
A
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
X
ZB4A16473902 12/01/2015 12/01/2016
TO
100,00
CLAIMS -MADE OCCUR
PREM_DAWAISES (RENTED
PREMIEa occurrencel_ _
$
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY JEST _ LOC
PRODUCTS - COMP/OP AGG
$ 2,000,000
----------
--- ------
OTHER:
$
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
ANY AUTO
ZB4A16473902
12/01/2015
12/01/2016
BODILY INJURY (Per person)
$
ALL OWNED SCHEDULED
BODILY INJURY (Per accident)
$
AUTOS AUTOS
PROPERTY DAMAGE
$
X X NON -OWNED
HIRED AUTOS AUTOS
(Per accident)
X
UMBRELLA LIAB X OCCUR
EACH OCCURRENCE
$ 1,000,00
AGGREGATE
A
EXCESS LIAB CLAIMS -MADE
UH4A16476202
12/01/2015
12/01/2016
$
DED... RETENTION_
$
Aggregate
$ 11000,00
$
WORKERS COMPENSATION
X STATUTE ERH
IS
YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
N /A
4172048
04/01/2015
04/01/2016 _E.L. EACH ACCIDENT
- - - — — —
$ 100,00
-- -- -- —
(Mandatory inNH)
E_.L_. DISEASE - EA EMPLOYE
$ 100,00
If yes, describe under
DESCRIPTION OF OPERATIONS below
---�-
E.L. DISEASE - POLICY LIMrr1
S 500,000
A
Property
ZB4A16473902
12/01/2015
12/01/2016 BPP 97,957
A
Crime (Includes Burg
ZB4A16473902
12/01/2015
12/01/2016 Ded. 1,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability.
CFRTIFICATF 1401 r)FR CANCFI I ATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City f Fort Collins
y o
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
215 North Mason Street
Fort Collins, CO 80524
AUTHORIZED REPRESENTATIVE
©1988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD