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HomeMy WebLinkAboutFRONT RANGE INSTITUTE OF SAFETY ( MARK ROSOFF ) - INSURANCE CERTIFICATEFRINS-1 OP ID: P6 ATE CERTIFICATE OF LIABILITY INSURANCE 12/19/2017Y) 12/19/2017 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 CNAME:ONTACT House Account Brown &Brown Inc PHONE 970-482-7747 FAX 9 4532 Boardwalk Dr, Suite 200 A/c No Ell: aJc No : 70-484-4165 Fort Collins, CO 80525 E-MAIL House Account ADDRESS: _ INSURED Front Range Institute of Safety, Mark Rosoff dba: 1437 Summitview Drive Ft Collins, CO 80524 INSURERS AFFORDING COVERAGE NAIC q INSURER A: Scottsdale Insurance Company 41297 INSURER B:The Charter Oak Fire Ins Co 25615 INSURERC: INSURER 0: INSURER E : INSURER F : COVFRAGFS CFRTIFICATF NI IMRFR• RFzvlgl 1N NI IMRFR• 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 OF INSURANCE MOM SUBR1 POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDNYYY MM/DDNYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE FxI OCCUR X CPS2709068 06/27/2017 06/27/2018 DAMA E TO RENTED100,00 PREMISES Ea occurrence $ MED EXP (Any one person) $ Exclude PERSONAL & ADV INJURY $ 1,000,00 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 POLICY PRO- JECT 7 LOC PRODUCTS -COMP/OP AGG $ Exclude r $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) ANY AUTO $ ALL OWNED SCHEDULED AUTOS AUTOS $ BODILY INJURY (Per accident) NON -OWNED HIRED AUTOS AUTOS PROPER accidentDAMAGE $ a UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ EXCESS LAB DED RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE F OFFICER/MEMBER EXCLUDED? (Manila. ry ?n NH) N/A UBOK2977091842G 01/25/2018 01/25/2019 PE OTH- X STATUTE ER E.L. EACH ACCIDENT $ 100,00 E.L. DISEASE - EA EMPLOYEE $ 100,00 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Instruction in First Aid & CPR - City of Fort Collins is included as Additional Insured on the General Liability as respects the operations of the named insured per form CG2010 4-13 l+tK I IrllrA I t MULUtK (;ANL:tLLA I IUN CITYF10 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. 413 S. Bryan Ave. Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD