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HomeMy WebLinkAbout113874 FOOD BANK FOR LARIMER COUNTY - INSURANCE CERTIFICATE (10)AC� ® DATE (MM/DDNYYY) CERTIFICATE OF LIABILITY INSURANCE F7/5/2017 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 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:Jordan Hartman, CISR NAME: HONE Ext: (720) 977-6017 A/C No: (970)506-6846 Flood and Peterson CPA/C. Corporate Mailing Address: E-MAIL ADDRESS: JIiartman@F1oodPeterson.com P.O. BOX 578 INSURERS AFFORDING COVERAGE NAIC # Greeley CO 80632 INSURERA:Philadelphia Indemnitv Ins. Co. 118058 ..aun INSURER B : Food Bank For Larimer County INSURER C : 1301 Blue Spruce Drive INSURERD: INSURER E : Fort Collins CO 80524 INSURERF: rOVFRAnFR CFRTIFICATF NIIIIARFR-CL177518596 RFVICIrI AI RIIIIIARGD- 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 LTR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM DD/YYVY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE FX7 OCCUR DAMAGE TO RENTED PREMISES Ea occurrence $ 100,000 MED EXP (Any one person) _ $ 5,000 PHPK1678955 07/01/2017 07/01/2018 PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRO JECT LOC 2,000,000POLICY $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A ANY AUTO ALL OX SCHEDULED AUTOS AUTOS PHPK1678955 07/01/2017 07/01/2018 BODILY INJURY (Per accident) $ X HIRED AUTOS X NON -OWNED AUTOS PROPERTY DAMAGE Per accident $ Uninsured Motorist $ 100,000 X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 4,000,000 AGGREGATE $ 4,000,000 A EXCESS LIAB CLAIMS -MADE DED X ( RETENTION $ 10,000 $ PHUB591736 07/01/2017 07/01/2018 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A E.L. DISEASE - EA EMPLOYE $ (Mandatoryin NH) If yes, describe under I E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS below $ A Directors & Officers Liab. PHSD1240444 07/01/2017 07/01/2018 Aggregate $2,000,000 Employment Practices Liab. Retention $25, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) L;tH I It-IL;A I t HULUtF1 L;ANL;tLLA I IUN City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 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 B Danielson, CISR/BDA © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)