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HomeMy WebLinkAboutCOLUMBINE MANAGEMENT SERVICES - INSURANCE CERTIFICATE (4)ACOR a► COLUM-8 CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 06/28/2017 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 have ADDITIONAL INSURED provisions or 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 endorsements). 970-356-8030 CONTACT Michael J Schmitt CIC PRODUCER NCMF' Rich & Cartmill Ins of CO of Colorado LLC 8213 W. 20th Street Greeley, CO 80634 Michael J Schmitt CIC INSURED Columbine Management Services Inc. 802 West Drake Road Suite 101 Fort Collins, CO 80526 INSURER F ..- 970-356-8030 Health Cap RRG Travelers Prop Cas Co of Am State National Insurance 970-356-8032 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 CONDI T ION 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 ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP p _. 1MW0QLY�YY MMID_D./.YYYYJ- _LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,OOQ CLAIMS -MADE OCCUR X HRG-0001-0001-OC-14 07/01/2017 07101/2018 'REMSDAMAGE TO RENTED 'ESE. oc 100,000 MED EXP An one person)5,000 _ X Professional Liab PERSONAL & ADV INJURY 1,000,000 3,000'000 EN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE _ POLICY ❑ j�7 ❑X LOC PRODUCTS -COMP/OP A G Included Emp Ben. 11000,000 OTHER: - - - -- B COBIND amdeW) INGLE LIMIT 11000,000 AUTOMOBILE LIABILITY Ea $ X ANY AUTO BA5E978078 07/01/2017 07/01/2018 BODILY INJURY Per arson $ OWNED SCHEDULED AUTOS ONLY AUTOS BO�DILY INJURYSPer accident pp AUTOS AUTOS ONEY PPeOrecEcidenDAMAGE ONLY UMBRELLA LIAB OCCUR HCLAIMS-MADE EACH OCCURRENCE $ EXCESS LIAB AGGREGATE ED RETENTION $ DOTH- — -- — -- _ C WORKERS COMPENSATION PER X R AND EMPLOYERS' LIABILITY NDE086448217 01/01/2017 01/01/2018 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE a E.L. EACH ACCIDENT _ OFFICER/MEMBER EXCLUDED? NIA 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT 1,000,000 �ES TION F O RATI y S / CATIO / V H L (ACOR 01, Additlo al emarks Schedule, a be attached if more space is required) ��he �ity o orrt o�llins, a unicipa7 GRorporation, �tt�n: er�I icate%o�Ser: Bob Adams, Director of Purchasing and Risk Management ""'See Notes— CIT-FOR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. (see above) c/o Purchasing Department AUTHORIZED REPRESENTATIVE PO Box 580 Michael J Schmitt CIC Fort Collins, CO 80522 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NOTEPAD. HOLDER CODE CIT-FOR COLUM-8 PAGE 2 INSURED'S NAME Columbine Management Services OP ID: DP Date 06/28/2017 The City of Fort Collins, a Municipal Corporation is listed as additional insured as pertains to the General Liability policy, per written contract.