HomeMy WebLinkAbout102624 PLATTE RIVER POWER AUTHORITY - INSURANCE CERTIFICATE (6)ACOR" CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY)
2/28/2017
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 Nick Rolph, CISR
NAME,Flood and Peterson PHA/CNNO El: (970)266-7139 FAAX No: (970)506-6845
PO Box 578 ADDRESS: NRolph@floodpeterson.com
Greeley CO 80632 INSURER A:Philadel hia Indemnity Insurance 18058
INSURED INSURER B :
Platte River Power Authority INSURERC:
2000 E. Horsetooth Road INSURERD:
INSURER E :
Fort Collins CO 80525 INSURER F:
Cr)VFRAr;FR CFRTIFIr`ATG A11111ARCQ•2nl7-1 R MDCTRA nr�nor, err nuu�nrn-
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
LTp
TYPE OF INSURANCEINSD
ADDL
SUBR
I WVQ
I POLICY NUMBER
POLICY EFF
MM/DDNYYY
POLICY EXP
MM/DDNYYY
LIMITS
Ii COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE OCCUR
EACH OCCURRENCE
$
DAMAGE TO RENTED
PREMISES Ea Occurrence
$
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO -
POLICY JECT LOC
OTHER:
GENERAL AGGREGATE
$
PRODUCTS - COMP/OP AGG
$
$
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OSCHEDULED
AUUTOSS AUTOS
X NON -OWNED
HIRED AUTOS AUTOS
PHPK1617921
3/1/2017
3/1/2018
EOa aBINED SINGLE LIMIT
(ccidenA
$ 1,000,000
X
BODILY INJURY (Per person)
$
BODILY INJURY Per accident)
$
X
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAR
EXCESS LIAB
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
$
AGGREGATE
$
DED RETENTION
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YEN
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
yes, describe under D
DESCRIPTION OF OPERATIONS below
N/A
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
a."n r L:ANGtLLA I IUN
City of Fort Collins
PO Box 580
Ft Collins CO 80522-0000
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
Rolph, CISR/NROLPHf
01988-2014 ACORD CORPORATION. All rights reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD
INS025 (201401)