HomeMy WebLinkAbout517670 HOMELESS GEAR - INSURANCE CERTIFICATE (3)HOMEL-1 OP ID: DP
,d►coR[� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
02/22/2017
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 CONTACT
NAME: Michael J Schmitt CIC
Rich 81 Cartmill Ins of CO PHONE
of Colorado LLC (A c, No Ex0 970-356 8030 _ I-F No)_ _970 356-8032
8213 W. 20th Street AD RIESSL _
Greeley, CO 80634 - -- T
Michael J Schmitt CIC __ INSURER(S) AFFORDING COVERAGE _____ _ NAIL p
INSURER A: Philadelphia Insurance Co _ 23850
INSURED Homeless Gear, Inc. INSURER B : _ _
1305 Duff Drive, Unit 5
Fort Collins, CO 80524
INSURER C :
INSURER D :
F:
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THIS IS TO CERTIFY THAT THE FOUCIES OF INSURANCE LISTED SELOVV 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 I POLICY EFF POLICY EXP LIMITS
LTR TYPE OF INSURANCE INSD WVD I POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
A
X
COMMERCIAL GENERAL LIABILITY 'i
EACH OCCURRENCE
1,000,00
-
CLAIMS -MADE X OCCUR
X
PHPK1615066 03/08/2017
03/08/2018
AGETO RTNTE6
PREMISES Ea occurrence
_$
$ 100,00
$ 5,00
MED EXP (Any one person)
$ 1,000,00
PERSONAL 8 ADV INJURY
GENERAL AGGREGATE
GENT
AGGREGATE LIMIT APPLIES PER
$ _ 3,000,00
X
PRODUCTS - COMPIOP AGG
$ _ 3,000,00
POLICY PRO ❑ LOC
JECT
--
OTHER.
AUTOMOBILE LIABILITY
Ee aCOMocidentJ-INED LE LIMIT
--- -----
$
BODILY INJURY (Per person)
$
ANY AUTO
I
-
BODILY INJURY (Per accident)
$
ALL OWNED SCHEDULED
AUTOS AUTOS
NON -OWNED
HIRED AUTOS AUTOS
PROPERTY DAMAGE
Per accident
$
$
UMBRELLA LIAR
OCCUR--
EACH OCCURRENCE
$ _
AGGREGATE
EXCESS LIAB_
CLAIMS -MAD
-T-
IDED RETENTION $
$
WORKERS COMPENSATION
PER OTH-
ST_ATUTE ER
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
-
E.L. DISEASE - EA EMPLOYEE
OFFICER/MEMBER EXCLUDED? ❑
(Mandatory in NH)
N / A
$
E.L. DISEASE -POLICY LIMIT
If yes, describe under
DESCRIPTION OF OPERATIONS below
_
$
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
The City of Fort Collins, its officers, agents, employees and volunteers are
additionally insured as it relates to the Mission of Hope Walk which will be
held on December 3, 2016.
CERTIFICA I t HULUtK V/11rVLLLM 1.-
CIT-FOR
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.
Risk Management
PO Box 580 AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80522 Michael J Schmitt CIC
U 19813-ZU14 ACUKU CUKYUKA I IUN. AU ngnis re5erveu.
ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD