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Home My WebLink AboutHOPE LIVES BREAST CANCER SUPPORT CENTER - INSURANCE CERTIFICATEOP ID: SLS ACG7R0 CERTIFICATE OF LIABILITY INSURANCE DATE/05/I2 Y01 04057 �..•--�'- 7 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 Phone: 970-223-1804 CONTACT NAME: Front Range Insurance Group PHONE PAX 1100 Haxton Drive Suite 100 Fax: A/c No Ext : A/C No): Fort Collins, CO 80525 E-MAIL ADDRESS: David A. Wooldridge LUTCFAAI PRODUCE.cR ,n „.HOPEL-1 „or INSURED Hope Lives Breast Cancer Support Center 2629 Redwing Rd., Ste. 260 Fort Collins, CO 80526 INSURER(S) AFFORDING COVERAGE I NAIC # A : Secura Insurance Companies 22543 B : Pinnacol Assurance 141190 INSURER D : INSURER E : nOVFRAhFS rFRTIFICATF NIIMRFR• 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 LTR TYPE OF INSURANCE DDL UB POLICY NUMBER MM/DDR POYIYYYY POLICY EXP MM DO/YYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX7 OCCUR X CP3163845 04/23/2017 04/23/2017 04/23/2018 04/23/2018 EACH OCCURRENCE $ 1,000,00( PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 10,00 PERSONAL & ADV INJURY $ 1 ,000,00 X Prof. Liability GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER', X POLICY PRO JECT LOC PRODUCTS - COMP/OP AGG $ 2,000,00 Prof. Lia $ 1,000,00 A A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS CP3163845 iCP3163845 04/23/2017 04/23/2017 04/23/2018 04/23/2018 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ X X $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CU3211864 04/23/2017 04/23/2018 EACH OCCURRENCE $ 2,000,00 AGGREGATE $ 2,000,00 DEDUCTIBLE RETENTION $ $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY/N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4054479 04/01/2017 04/01/2018 X I WC STATU- OTH- TDRY LIMITS I I ER E.L. EACH ACCIDENT $ 1,000,00 E.L. DISEASE - EA EMPLOYE $ 1,000,00 E.L. DISEASE - POLICY LIMIT $ 1,000,00 A Bus Pers Prop CP3163845 04/23/2017 04/23/2018 BPP 5,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is named as additional insured with respects to General Liability policy. Event: Hope Lives "Pink Boa" 5R Run/Walk Date: 6/4/16 f CDTICIrATC L.Ini nr-O rANrFI I ATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Risk Management PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 U 1968-2009 AGURD GUKPURAI IUN. All rlgnts reserveo. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD