HomeMy WebLinkAbout579202 ROOTED COLORADO - INSURANCE CERTIFICATESAMPLE INSURANCE GRP
PO BOX 790
MONUMENT, CO 80132
COMMERCIAL
CITY OF FT COLLINS
P.O. BOX 580
FORT COLLINS, CO 80522
Additional insured endorsement
Name of Person or Organization
CITY OF FT COLLINS
P.O. BOX 580
FORT COLLINS, CO 80522
Policy number: 03997856-0
Underwritten by:
Artisan and Truckers Casualty Co
Insured: ROOTED COLORADO
December 7, 2016
Policy Period: Dec 2, 2016 - Dec 2, 2017
Mailing Address
Artisan and Truckers Casualty Co
PO Box 94739
Cleveland, OH 44101
1-800-444-4487
For customer service, 24 hours a day,
7 days a week
The person or organization named above is an insured with respect to such liability coverage as is
afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of
another insured and then only to the extent of that liability. We also agree with you that insurance
provided by this endorsement will be primary for any power unit specifically described on the
Declarations Page.
Limit of Liability
Bodily Injury Not applicable
Property Damage Not applicable
Combined Liability $1,000,000 each accident
All other terms, limits and provisions of this policy remain unchanged.
This endorsement applies to Policy Number: 03997856-0
Issued to (Name of Insured): ROOTED COLORADO
Effective date of endorsement: 12/02/2016
Form 1198(01/04)
Policy expiration date: 12/02/2017