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HomeMy WebLinkAbout315931 BIG THOMPSON WATERSHED FORUM - INSURANCE CERTIFICATE (11)A � CERTIFICATE OF LIABILITY INSURANCE iiiii20 )7 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/C NNE.,Ext): � C,No): (888) 443-6112 -ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL# INSURERA: Twin City Fire Ins Co MURm BIG THOMPSON WATERSHED FORUM 800 S TAFT AVE LOVELAND CO 80537 INSURER B INSURER C : INSURER D: INSURER E: 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. INSR TYPE OFINSUWANCE ADDI SVBA POLICYNUAIER ( POLICTEFF POLICYEXP LETS 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: POLICY ECT ❑ LOC OTHER: GENERAL AGGREGATE PRODUCTS -COMP/OP AGG g $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) UMBRELLA LLAB EXCESS LUU3 OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DE RETENTION $ $ A WORZEBSCOMPENSATTON AN'DEMPLOYERS`I.7ABILITY ANY PROPRIETORIPARTNERIEXECUTIVEY/N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) ❑ If yes, describe under DESCRIPTION OF OPERATIONS below RiA 76 WEG PE5980 01/01/2018 01/01/2019 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $10 0 , 000 E.L. DISEASE- EA EMPLOYEE I100r000 E.L. DISEASE -POLICY LIMIT $ 5 0 0 000 DESCRIPTION OFOPERATIONS /LOCATIONS / VEWCPNMRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER 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. Fort 4316 Collins W T P LAPORTE AVE AUTHOR 2FD REPRESENrAnVE C1►tf� G G7i�, FORT COLLINS, CO 80521 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD