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HomeMy WebLinkAbout130692 LARIMER COUNTY - INSURANCE CERTIFICATE (3)A`/^� ® DATE (MM/DD/YYYY) V CERTIFICATE OF LIABILITY INSURANCE F5/23/2018 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 CON ACT NAME: Nathan Kathol Arthur J. Gallagher Risk Management Services, Inc. PHONE FAx 6300 South Syracuse Way, Suite 700 c N xt: 303-889-2574 Arc No: Centennial CO 80111 ADDRESS: Nathan_Kathol@ajg.com INSURED Larimer County, Colorado 200 W. Oak Street Suite 4000 Fort Collins CO 80522 1 INSURER A: Argonaut Insurance INSURER C : INSURER D : INSURER E: COVERAGES CERTIFICATE NUMBER: 1520425981 REVISION NLJMBFR- NAIC # 19801 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 TR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MM/DD POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY Y 290201903 5/15/2018 5115/2019 EACH OCCURRENCE $1,000,000 CLAIMS -MADE Fil OCCUR DAMAGE TO RENTED PREMISES Ea occurrence S MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $1,000,000 X POLICY PRO- _JECT LOC PRODUCTS-COMP/OPAGG $ OTHER: $ A AUTOMOBILE LIABILITY 290201903 5/15/2018 5/15/2019 COMBINED SINGLE LIMIT Ea accident $1.000,000 X BODILY INJURY (Per person) ANY AUTO $ OWNED SCHEDULED AUTOS ONLY AUTOS $ BODILY INJURY (Per accident) HIRED NON -OWNED AUTOS ONLY AUTOS ONLY PROPERTY DAMAGE Per acciden E $ E UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE t EXCESS LIAB CLAIMS -MADE DED RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N PEROTH- STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBEREXCLUDED? N/A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE S (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) The City of Fort Collins is Additional Insured as respects General Liability policy, pursuant to and subject to the policy's terms, definitions, conditions and exclusions. RE: Revocable Permit for Access on City property, Front Range Trail project on Flores Del Sol Natural Area Dates: March 1, 2017 through February 28, 2018 Location: Exhibit A - The N1/2 of the SE 1/4 of Section 19, Township 6 North, Range 68 West of the 6th P.M., County of Larimer, State of Colorado. Execpting therefrom that part conveyed to the Board of County Commissioners in Deed of Dedication recorded May 4, 1994 at Reception No. 94039129. (Vacant land, no street address assigned.) CERTIFICATE HOLDER CANCELLATION City of Fort Collins, Risk Management PO Box 580 Fort Collins CO 80522-0580 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 PRESENTATIVE Z. X,1, © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD