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HomeMy WebLinkAboutPB PROPERTIES - INSURANCE CERTIFICATEACOROa DATE (MM/DD/YYYY) 14�C" CERTIFICATE OF LIABILITY INSURANCE F9125/2017 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 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 endorsements . PRODUCER CONTACT Scott Anderson CIC Commercial Risk Solutions 6600 E Hampden Ave Ste 200 Denver CO INSURED PB PropPerties LLC 1768 4 152nd Avenue Broomfield CO 80023 PRADE-1 NAME- I _ PHONE Ex� 303-996-7833 FAx 303 757-7719 (AIC E-MAIL sanderson@crsdenver.com 1�FSS:__ INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Pinnacol Assurance 41190 INSURER B: Nationwide INSURER C : E: I I INSURER F : I n0VFRAnF1r1 r:FRTIFICATF NI IMRF17. 1143423487 DI:111CInrd lUI IMRFI?- 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 TYPE OF INSURANCE POLICY EFF POLICY EXP LIMITS LTR I D WVD POLICY NUMBER MlDD/YY DIYYYY B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X j OCCUR Y ACP3017333559 9/22/2017 1912212018 EACH OCCURRENCE $1,000,000 AWAGE'rb RENTED PREMISES Ea occurrence_ $300,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 Hired & NonOwned $Included B AUTOMOBILE LIABILITY ANY AUTO OWNED X SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY X AUTOS ONLY ACP3017333559 9/22/2017 9/22/2018 COMBINED SINGLE LIMIT Ea accident $ 1,0000,000 BODILY INJURY (Per person) $ X BODILY INJURY (Per accident) $ oPE7 ryzANrAGe--- JPer accident_ $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE ACP3017333559 9/22/2017 9/22/2018 EACH OCCURRENCE $5,000,000 AGGREGATE $5,000,000 DED X RETENTION$0 $ A !!WORKERS COMPENSATION IANDEMPLOYERS'LIABILITY Y/N '. ANY PROPRIET ER EXCLUDED' ECUTIVE � OFF(Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below N /A 4176845 2/1/2017 2/1/2018 X 1 PER STATUTE EORH E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYE $1,000,000 E.L. DISEASE - POLICY LIMIT 1 $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins is included as additional insured on the General Liability with respect to ongoing operations of the named insured for the certificate holder as required by written contract. All policy terms, conditions and exclusions apply. CERTIFICATE HOLDER CANCELLATION City of Fort Collins 281 North College Avenue, 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 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD