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Home My WebLink AboutCOLORADO STATE UNIVERSITY - INSURANCE CERTIFICATE (4)A` ORS CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) I 07l31l2017 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 endorsement(s). PRODUCER Aon Risk Services South, Inc. Franklin TN office CONTACT NAME: PHONE (866) 283-7122 FAX (800) 363-0105 (A/C. No. Ext): (A/C. No.): E-MAIL ADDRESS: 501 Corporate Centre Drive suite 300 INSURER(S) AFFORDING COVERAGE NAIC # Franklin TN 37067 USA INSURED INSURER A: Safety National Casualty Corp 15105 INSURER B: Lloyd's syndicate No. 2987 AA1128987 Colorado state University 1251 Mason Street Fort Collins Co 80523-6021 USA INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570067817760 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. Limits shown are as requested LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER POLICY MMlDD/YYYY I tAF MM/DUY DlYYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR PK1033617 SIR applies per policy terns 08/01 & conditions 1 EACH OCCURRENCE $1 , 000 , 000 DAMAGE TO RENTED PREMISES Ea occurrence Included MED EXP (Any one person) PERSONAL &ADV INJURY Included GEN'LAGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE $1,000,000 PRODUCTS - COMP/OPAGG Included POLICY ❑ PRO X JECT ❑ LOC OTHER. B AUTOMOBILE LIABILITY PK1033617 SIR applies per policy terns 08/01/2017 & conditions 08/01/2018 COMBINED SINGLE LIMIT Ea accident BODILY INJURY ( Per person) $1 , 000 , 000 X ANY AUTO BODILY INJURY (Per accident) OWNED SCHEDULED AUTOS ONLY AUTOS HIRED AUTOS NON -OWNED ONLY AUTOS ONLY DAMAGE (Per accd nt B X UMBRELLA LIAB EXCESS LIAB HOCCUR CLAIMS -MADE PK1033617 SIR applies per policy terns 08/01/2017 & conditions 08/01/2018 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED I X RETENTION WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR / PARTNER / EXECUTIVE PER OTH- STATUTE I ER E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) N / A E.L. DISEASE -EA EMPLOYEE If yes, describe under E.L. DISEASE -POLICY LIMIT A DESCRIPTION OF OPERATIONS below Excess WC sp4057454 SIR applies per policy ter 08/01/2017 s & condi 08/01/2018 ions EL Each Accident EL Disease - Policy S1,000,000 $1,000,000 EL Disease - Ea Emp $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Rec Sports Baseball team, Field Rental from City of Fort Collins for 2017 season. The City of Fort Collins is included as Additional Insured on General Liability Policy if required by written contract or agreement subject to the policy terms and conditions. CERTIFICATE HOLDER CANCELLATION City of Fort Collins Attn: Risk Management 215 N. Mason Street, 2nd Floor PO Box 580 Fort Collins CO 80522 USA 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 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD `m 0 r 00 0 0 0 0 Z N U U d U ACORD 25 (2016/03)