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HomeMy WebLinkAbout566707 COLORADO IN MOTION - INSURANCE CERTIFICATE (2)DATE (MM/DD/YYYY) ACCW?" CERTIFICATE OF LIABILITY INSURANCE 10/2/2017 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 Robert Rendon NAME: _ John C Beckett and Associates Inc PHONE (970)484-2805 1 FAX (970)484-2885 (A/C, No E),d),, A/C No): 220 Smith Street E-MAIL robert@beckettinsurance.com ADDRESS:_ INSURERS) AFFORDING COVERAGE NAIC # Ft. Collins CO 80524_ INSURER A :CRC Swett INSURED INSURER B :Columbia Insurance Company Colorado Physical Therapy Specialis, DBA: Colorado INSURERC:PROASSURANCE SPE_C_IALTY INC CO. 210 W. Magnolia, Suite 110 INSURERD: INSURER E : _ Fort Collins CO 80524 INSURER F rn110oA11_00 /^rDTIrIL'ATF All IMRFD•CL1.772101132 RFVISION 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. IR TYPE OF INSURANCE IN R POLICY POLICY EXY LIMITS LT F LTR ' POLICY NUMBER �Y COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE x , OCCUR DAMA(�TO RENTED PREMISIESIEa occurrence $ MED EXP (Any one person) $ X CR161597 7/8/2017 7/8/2018 $ PERSONAL 8 ADV INJURY AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 1,000,000 GEN'L X ] POLICY n PRO LOC L._J JECT PRODUCTS - COMP/OP AGG $ --..._._ Employee Benefits $ 1 OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE L MIT Ea accident $ 1,000,000 — BODILY INJURY (Per person) — $ B ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED X HIRED AUTOS AUTOS 71APR342026 10/4/2016 10/4/2017 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ UMBRELLA LIAB OCCUR NO COVERAGE EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? i� (Mandatory in NH) N f A NO COVERAGE STATUTE ER E.L EACH ACCIDENT E.L. DISEASE - EA EMPLOYE $ $ 1 $ "yes, disc the under DESCRIPTION OF OPERATIONS below i ...--- E.L. DISEASE - POLICY LIMIT C E60 AFC9266916 110/11/2016 10/11/2018 EACH OCCURRENCE 1,000,000 GENERAL AGGREGATE LIMIT 3,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER IS AN ADDITIONAL INSURED PER WRITTEN CONTRACT ON THE GENERAL LIABILITY FOR THE ONGOING OPERATIONS OF THE INSURED. r;=PTIFIr_ATF Hr11 r1FR CANCELLATION (970)221-6775 CITY OF FORT COLLINS ACCOUNTING DEPARTMENT PO BOX 580 FORT COLLINS, CO 80522-0580 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 Robert Rendon/RR © 1988-2014 ACORD CORPORATION. All rights reserves. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)