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HomeMy WebLinkAbout315931 BIG THOMPSON WATERSHED FORUM - INSURANCE CERTIFICATE (10)CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) �12/5/2016_ THIS CERTIFICATEIS 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 PAYCHEX INSURANCE AGENCY INC 210705 P: F:(888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAMEPHONE : (AIC.Na. Ext) IF (AC.No): (888) 443-6112 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC# INSURERA: Twin City Fire Ins Co INSURED BIG THOMPSON WATERSHED FORUM 800 S TAFT AVE LOVELAND CO 80537 INSURER B : INSURER C : INSURER D: INSURER E: INSURER F: r_nVFRAnFS CFRTIFICATF NUMBER: 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. LN.L! TYPE OFJIVSURANCE _IDDL SUBR POLICYNUMBER POLICYEFF DD YYYY! POLICYEXP LLWTg COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 CLAIMS -MADE ❑OCCUR DAMAGES (RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) PERSONAL & ADV INJURY $ GEN'LAGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ PRODUCTS -COMP/OPAGG $ POLICY PRO LOC JECT $ OTHER: SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) (Ea BODILY INJURY (Per person) 5 ANY AUTO OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS PROPERTY DAMAGE (Peraccident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS -MADE AGGREGATE $ D RETENTION $ 5 WORKERS COWENSAU0N AND EEVlOTERS') AUUJTF ANY PROPRIETORIPARTNER/EYECUTIVEY/N X PER SiAME ER. E.L. EACH ACCIDENT 15100, 000 A OFFICER/MEMBEREXCLUDED? (Mandatory in NH) ❑ WA 76 WEG PE5980 01/01/2017 01/01/2018 E,L.DISEASE-EA EMPLOYEE $100, 000 If yes, describe under E.L. DISEASE -POLICY LIMIT $ rj 0 0 0 0 0 DESCRIPTION OF OPERATIONS below , DESCRIPTION OF OPERATIONS/LOCATIONS/ VEH/C(AODRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. r"t=ATICIr'ATI= Un1 r11=0 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED The City Of Fort Collins Y BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ` Fort Collins WTP 4316 LAPORTE AVE 7A-z—��li..�_� FORT COLLINS, CO 80521 ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORD 25 (2016103)