HomeMy WebLinkAbout102622 POUDRE SCHOOL DISTRICT R-1 - INSURANCE CERTIFICATE (2)COLORADO SCHOOL DISTRICTS SELF INSURANCE POOL
CERTIFICATE OF COVERAGE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON
THE
07/01/2017
CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND
OR
ALTER THE COVERAGE AFFORDED BY THE
POLICY BELOW. THIS CERTIFICATE OF INSURANCE DOES
NOT
CONSTITUTE A CONTRACT BETWEEN
THE ISSUING INSURER, AUTHORIZED REPRESENTATIVE
THE
CERTIFICATE HOLDER.
MEMBER:
POUDRE SCHOOL DISTRICT R-1
Colorado School Districts Self
ATTN:
Kristin Bennett
Insurance Pool, 6857 South Spruce St.
ADDRESS:
2407 LA PORTE AVENUE
Centennial, Colorado 80112
CITY, STATE ZIP:
FORT COLLINS, CO 80521 2297
(303) 722-2600
(303) 722-7888 Fax
POLICY NUMBER:
6216-17-00215
POLICY PERIOD:
07/01/2017 to 07/01/2018
THIS IS TO CERTIFY THAT THE POLICY OF COVERAGE LISTED BELOW HAS BEEN ISSUED TO THE MEMBER 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 COVERAGE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS, DEFINITIONS AND CONDITIONS OF SAID POLICY. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF COVERAGE
LIMITS/DEDUCTIBLES
SCHOOL ENTITY LIABILITY
Occurrence Form
EACH OCCURRENCE, SCHOOL LEADERS WRONGFUL ACT
$10,000,000
& EMPLOYMENT WRONGFUL ACT
ANNUAL AGGREGATE LIMIT
$10,000,000
MEDICAL EXPENSE (PER PERSON/PER ACCIDENT)
$1,000/$10,000
SCHOOL AUTO
Any Auto, Hired and Non -Owned
LIMIT PER ACCIDENT
$5,000,000
Medical Payments
LIMIT PER ACCIDENT/PER PERSON
$5,000
Auto Physical Damage Coverage
AUTO PHYSICAL DAMAGE DEDUCTIBLE
$10,000
PROPERTY
Special Form
BUILDING/BUSINESS PERSONAL PROPERTY LIMIT
$814,245,782
DEDUCTIBLE
$100,000
PROPERTY DAMAGE TO PREMISES RENTED TO YOU
$500,000
DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES SPECIAL ITEMS
Certificate Holder is included as an
Additional Insured on the Member's School Entity Liability Coverage
& Auto Liability
Coverage for "bodily injury", "personal
injury" or "property damage" caused by the Member's negligence
if required by
written contract or agreement subject
to the policy terms and conditions with respects to any function or
activity held on
the Certificate Holder's premises during the policy period.
CANCELLATION: SHOULD THE ABOVE DESCRIBED
POLICY BE
CERTIFICATE HOLDER:
CANCELLED BEFORE THE EXPIRATION DATE,
WE WILL ENDEAVOR
TO MAIL 30 DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER
NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF
ANY KIND UPON THE
COMPANY, ITS AGENTS OR REPRESENTATIVES.
City of Fort Collins Risk Management Department
P O Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins, CO 80521
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