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ROCKY MOUNTAIN STUDENT MEDIA CORPORATION - INSURANCE CERTIFICATE
77/31/2017 TE (MM/DD/YYYY) ACoRO® CERTIFICATE OF LIABILITY INSURANCE 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 Whitney Morgan, CLCS, CISR Flood and Peterson PHONE Xt. (970) 356-0123 FAUX NC: (970)330-1867 PO Box 578 E-MAIL wmorgan@floodpeterson.com eterson.com ADDRESS: INSURER(SI AFFORDING COVERAGE I NAIC M Greeley CO 80632 INSURED Rocky Mountain Student Media Corporation 1101 Centre Ave Mall, Room 118 :Pinnacol Assurance E: Insurance Comvanv 122306 Fort Collins CO 80523 1 INSURERF: rrrwrcncce CERTIFICATE NI IMRFR•CL1773118918 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 OF INSURANCE ADDLTYPE JN= SUER POLICY NUMBER PO LICY EFF DD/VYYY POLICY EXP M DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISESEaoccurence $ 1,000,000 MED EXP (Any one person) $ 5,000 _ X OD4 A997251 01 7/28/2017 7/28/2018 PERSONAL & ADV INJURY $ EXCLUDED I GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 2,000,000 JECT X POLICY PRO LOC $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) $ 1, 000, 000 BODILY INJURY (Per person) ANY AUTO A ALL OWNED SCHEDULED _ AUTOS AUTOS NON -OWNED X HIRED AUTOS X AUTOS OD4 A997251 01 7/28/2017 7/28/2018 $ $ $ BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 A EXCESS LIAB I CLAIMS -MADE OD4 A997251 01 7/28/2017 7/28/2018 DED X IRETENTION $ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? )3 (Mandatory in NH) NSA 4125313 7/1/2017 7/1/2018 X I STATUTE I ERH E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYE $ 500,000 E.L. DISEASE - POLICY LIMIT $ 500,000 If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. GLH I It-ICA I t MULUtM l,N1V6 CLL/1I IUIIA City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE W Morgan, CLCS, CISR/ © 1988-2014 ACORD CURPUHA I IUN. All rlgnts reserVeo. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201ao1)