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HomeMy WebLinkAboutRECREATION SYSTEMS II - INSURANCE CERTIFICATE (5)�..� RECRSYS-01 MSWAIM ,4�oRO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 07/27/2018 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 have ADDITIONAL INSURED provisions or 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). CONTACT PRODUCER AM E: _ _ — Forsberg Engerman Co $ 3575 S Sherman St (A/C, N , E:t): ( 03) 762-1717 ja , No):(303) 762-1733 Englewood, CO 80113 E-MAIL IIJCIIRFR/Cl AFFr1Rnmr: Cr1VFRACF NAIC # INSURER A:EMC Insurance Companies z1410 INSURED INSURER B : Plnnacol Assurance 41190 Recreation Systems II INSURER C : P.O. BOX 98 INSURERD: Commerce City, CO 80037-0098 INSURER E :.- INSURER F : DG\/ICInKI IVI IMRFR- 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 ADDL SUER POLICY NUMBER POLICY EFF Y POfDDrYYYYILICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE [-X]OCCUR3D27098 07/28/2018 07/28/2019 pRAEMGES eaoocu ence $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: POLICY ❑X PRO ❑ LOC JECT GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 OTHER $ A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident 1,000,000 $ BODILY INJURY Perperson) $ X ANY AUTO 3E27098 07/28/2018 07/28/2019 BODILY INJURY Per accident $ OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY R(peOPER- ntDAMAGE $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION $ $ B A WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY Y/N ANY OFFICER MEMBER EXCLUDED? PROPRIETOR/PARTNER/EXECUTIVE ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Inland Marine N / A 1090950 3C27098 04/01/2018 07/28/2018 04)01/2019 07/28/2019 TH- I PTAT T OER E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT Limit 1,000,000 $ 25,000 A Inland Marine 3C27098 07/28/2018 07/28/2019 Contractors Equip 22,731 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: City of Ft Collins Reliant Park CERTIFICATE HOLDER I.ANIitLLA I IUN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Ft Collins ACCORDANCE WITH THE POLICY PROVISIONS. 215 N Mason St Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) © 1988-2015 ACUKD GUKF'UKA I IUN. All rlgnis reservea. The ACORD name and logo are registered marks of ACORD