HomeMy WebLinkAbout174626 FORT COLLINS HABITAT FOR HUMANITY - INSURANCE CERTIFICATE (7)DATE
ACORL7® CERTIFICATE OF LIABILITY INSURANCE (MMlDD/03/O11201
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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 INSURERS(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
DONTACT
Lockton Affinity, LLC
P.O. Box 873401
HONE
A/C No.Ext): 888-553-9002
AX
A/c, No):
DDRESS:
Kansas City, MO 64187-3401E-MAIL
INSURER(S) AFFORDING COVERAGE
NAIC
NSURER-A: ACE American Insurance Co.
22667
INSURED
NSURER-B:
Fort Collins Habitat for Humanity
4001 S Taft Hill Rd,
Fort Collins, CO 80526-2948
NSURER-C:
NSURER-D:
NSURER-E:
NSURER-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.
IN
SR
LT
R
_ _ TYPE OF INSURANCE
ADDL
INSR
SUB
R
V4VD
POLICY NUMBER
POLICY EFF
MM/DD/YYYY)
POLICY EXP
MM/DDIYYYY)
LIMITS
A
GENERAL LIABILITY
X OMMERCIAL GENERAL LIABILITY
LAIMS MADE X OCCUR
X
GL1064502-17
04/01/2017
04/01/2018
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 1,000,000
MED EXP (Any oneperson)
$ 0
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
EN'LAGGREGATE LIMIT APPLIES PER :
X OLICY
PRODUCTS — COMP/OPAGG
$2,000,000
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED SCHEDULED
AUTOSAUTOS
NON -OWNED
AUTOS AUTOS
COMBINED
Ea accident)SINGLE LIMIT
$
BODILY INJURY Per Person
$
BODILY INJURY Per accident
$
__HIRED
PROPERTY DAMAGE
Per accident
$
MBRELLA LIAB
XCESS __ _
_
OCCUR
CLAIMS MADE
EACH OCCURRENCE
$
HAiLIAB
AGGREGATE
$
ED RETENTION $
ORKERS COMPENSATION
No EMPLOYERS' LIABILITY
NY PROPRIETOR/PARTNER/EXECUTIVE Y/N
C STATU-
CRY LIMITS
�TH-
R
FFICER/MEMBER EXCLUDED? I
E.L. EACH ACCIDENT
_
$
MANDATORY IN NH)
f yes, describe under
E.L. DISEASE — EA EMPLOYEE
$
DESCRIPTION OF OPERATIONS below
E.L. DISEASE — POLICY LIMIT
$
CERTIFICATE HOLDER 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
IAUTHORIZED REPRESENTATIVE I
City of Fort Collins
P.O. Box 580,
Fort Collins, CO 80522
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD
1064502