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WIDNER & MICHOW LLP - INSURANCE CERTIFICATE
CERTIFICATE OF LIABILITY INSURANCE NYYY [D�1� 5/2o 6) 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 endorsemen s . PRODUCER PAYCHEX INSURANCE AGENCY INC 210705 P: F: (888) 443-6112 PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: A/CNNEo,Exb: (aC.NoY (888) 443-6112 E-MAIL ADDRESS: INSURERS) AFFORDING COVERAGE NAIC# wsURERA: Twin City Fire Ins Co INSURED WIDNER & MICHOW LLP 13133 E ARAPAHOE RD STE 100 CENTENNIAL CO 80112 INSURER B INSURER C : INSURER D: INSURERE: INSURER F: COVERAGES CERTIFICATE 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. TYPE OFLNSU ONCE ADDL SUBR P0LTCYNUh1WER POL7CYEFF D YYIi' POLICYEXP LLMrTS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS -MADE ❑OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ MED EXP (Any one person) g PERSONAL & ADV I NJ URY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE g PRODUCTS - COMP/OP AGG g POLICY PRO- LOC JECT S OTHER: AUTOMOBILE LIABILITY SINGLE LIMIT (Ea (Ea accident) $ BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY 5 UMBRELLALUU3 OCCUR EACH OCCURRENCE $ AGGREGATE g EXCESS LIAB CLAIMS -MADE DE RETENTION $ WORXEILS COMPEKS477ON AND EMPLOYERS'LLABLLTTY ANY PROPRIETORIPARTNERIEXECUTIVEYIN X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ ] 0 0 , 000 A OFFICERIMEMBEREXCLUDED? (Mandatory in NH) El76 N/A WEG NS8200 12/01/2016 12/01/2017 E.L. DISEASE- EA EMPLOYEE '100r 000 If yes. describe under E.L. DISEASE - POLICY LIMIT " rj 0 0 000 DESCRIPTION OF OPERATIONS below , DESCRIP7ION OF OPERA 77ONS /LOCATIONS/ VEHIC(MDRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. CFRTIFICATF i4ni nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. THE CITY OF FORT COLLINS AUTHORIZED REPRESENTATIVE ` PO BOX 580 —77ezz---, - FORT COLLINS, CO 80522 /A—c— ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD