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RICHARD W. MARTIN - INSURANCE CERTIFICATE (2)
Allstate. You're In good hands. CERTIFICATE OF INSURANCE - COMMERCIAL ALLSTATE INSURANCE COMPANY - NORTHBROOK, IL THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Description of Operation: ATTORNEY CERTIFICATE HOLDER NAMED INSURED Name and Address of Party to Whom this Certificate is Issued Name and Address of Insured CITY OF FORT COLLINS RICHARD MARTIN 215 N MASON ST 155 BOARDWALK DR STE 400 FORT COLLINS, CO 80524-4402 FORT COLLINS, CO 80525-3040 Location Address (if different than above) This is to certifv that DOliciesof insurance listed below have been issued to the insured named above subject to the expiration date indicated below notwithstanding any requirement, term or cond ition of any contractor 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. TYPE OF INSURANCE AND LIMITS Policy Number: 648813342 Effective Date: 04-05-2018 Expiration Date: 04-05-2019 COVERAGE SUMMARY BUSINESS LIABILITY AMOUNT COMPREHENSIVE LIABILITY $ 1, 000, 000 Per Occurrence DAMAGE TO PREMISES RENTED TO YOU $ 50, 000.00 Any One Premises MEDICAL PAYMENTS $ 10, 000 Per Person OTHER THAN PRODUCTS / COMPLETED OPERATIONS AGGREGATE $ 2, 000, 000.00 PRODUCTS / COMPLETED OPERATION AGGREGATE r $ 2, 000, 000.00 PROPERTY INSURANCE POLICY TYPE 0 SPECIAL FORM ❑ BROAD FORM BASIC FORM BUILDERS RISK SPECIAL FORM BUILDING F7Repiacement Cost F-] Actual Cash Value Blanket Limit xx CONTENTS $ 10, 000 © Replacement Cost n Actual Cash Value Blanket Limit Deductible $ 500 Wind Deductible % 0 Exclude Wind11 YES NO ADDITIONAL COVERAGE'S: EQUIPMENT BREAKDOWN,PROFESSIONAL OFFICE SHIELD ENHANCEMENT MORTGAGE CLAUSE — The policy contains a Mortgage Clause in favor of: Mortgagee Ad d ress CERTIFICATE PERIOD THIS CERTIFICATE WILL REMAIN IN FORCE FROM THE INCEPTION OF THE POLICY UNTIL THE POLICY IS CANCELLED OR EXPIRES. POLICY INCEPTION DATE: 04-05-2018 ® 12:01 AM 12:00 NOON Standard Time at the location of the Insured Premises. PROVISIONS This form is not the contract of insurance, but attests that a policy as identified above has been issued. The provisions of the policy shall prevail in all respects. SHOULD THE ABOVE DESCRIBED POLICY BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. JEFF COMBS O4-05-18 Authorized Representative Date BU 114R-3 CICW010114 Cenificate Copy