HomeMy WebLinkAbout20021611 Client# : 12170 GRECI
ACORa CERTIFICATE OF LIABILITY INSURANCE DA6ji3%oa
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Ins . Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P. 0. Box 578 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
4687 W. 18th Street
Greeley, CO 80632 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Fairmont Insurance Company
City Of Greeley -
INSURER B:
dba Rocky Mountain Senior Games
INSURER G:
1010 6th Street
INSURER D:
Greeley, CO 80631
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR i POLICY EFFECTIVE POLICY EXPIRATION I
LTR TYPE OF INSURANCE I POLICY NUMBER DATE(MWDD/YY) DATE(MM/DDNY) LIMITS
A GENERAL LIABILITY ISSP3804243901 05/06/02 01/29/03 EACH OCCURRENCE $1, 000, 000
X COMMERCIAL GENERAL LIABILITY I FIRE DAMAGE(Any one fire) $300, 000 _--
CLAIMS MADE LXJ OCCUR I MED EXP(Any one person) $5, 000
PERSONAL S ADV INJURY 81, 000, 000_
GENERAL AGGREGATE sNone
GEN'L AGGREGATE LIM IT APPLIES PER: PRODUCTS -COMP/OP AGG $1, 000, 000
POLICY I I JEQT [ LOC *** $1, 000 , 00C
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
' ANY AUTO '(Ea accident)
ALL OWNED AUTOS BODILY INJURY
• SCHEDULED AUTOS (Per person) $
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident) $
PROPERTY DAMAGE $
(Per accident)
I GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO EA ACC $
-___ OTHER THAN
AUTO ONLY: AGG $
EXCESS LIABILITY • EACH OCCURRENCE $
AGGREGATE $OCCUR I j CLAIMS MADE I
DEDUCTIBLE •
RETENTION $ $
WORKERS COMPENSATION AND ITORYLMITS '�ER __. .
EMPLOYERS'LIABIUTY
E.L.EACH ACCIDENT _,$
E.L.DISEASE-EA EMPLOYEE $
I E.L.DISEASE-POLICY LIMIT $
OTHER I
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
*** Participant Legal Liability
The certificate holder is an additional insured per Form CG 2011 - Lessors
or Managers or Premises but only with respects to the operations of the
insured.
CERTIFICATE HOLDER ADDmONAL INSURED;INSURER LETTER: __ CANCELLATION
SHOULD ANYOF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Weld County CO By 8i through the DATE THEREOF, THE ISSUING INSURER WILL ENDEAV TO MAIL 0 DAYS WRITTEN
Board of County Commissioners NOTICETOTHE CERTIFICATE HOLD O TOTHEL ,BUTFAILURE TO DO SO SHALL
of Weld County, The Weld County IMPOSE OBLIGATION OR LI ILITY OF A KIND U THE INSURER,ITS AGENTS OR
Sheriff 8i their employees REPRESENTA vES.
915 10th Street Al1THORIZED RE ( y \
I Greeley, CO 80631 L
ACORD25-S(7/97)1 of 2 #5218135/M218129 DSM ' 2002-1611
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