HomeMy WebLinkAbout3 Sisters LLC - Insurance Certificate 2023 3SISTER-01 JKEYSER
'4�oRo CERTIFICATE OF LIABILITY INSURANCE DATE(M/202YYY)
6/21 2023
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).
PRODUCER CONTACT PFS Insurance
PFS Insurance Group P nxc,No (970)635-94014848 Thompson Parkway Suite 200 AO,NE,
Johnstown,CO 80534 E-MAIL ,info@mypfsinsurance.com
INSURERS AFFORDING COVERAGE NAIC#
INSURER A:Travelers Property Casualty Company of America 25674
INSURED
INSURER B
3 Sisters,LLC INSURER C:
1420 Riverside Avenue,Suite 114 INSURER D:
Fort Collins,CO 80524
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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.
ILTR NSR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
CLAIMS-MADE [�] OCCUR X 1-660-3D839862 6/27/2023 6/27/2024 DAMAGE TISESO R(EaENTED occurrence) $ 1,000,000
MED EXP(Any oneperson) $ 5,000
PERSONAL&ADV INJURY $ 1,000,000
GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY PRo LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMITfEa accident)
$
ANY AUTO BODILY INJURY Perperson) $
OWNED SCHEDULED
AUTOS ONLY AUTOS BODILY INJURY Per accident $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Per accident $
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EXCESS LIAR HCLAIMS-MADE AGGREGATE $
DED I I RETENTION$ $
WORKERS COMPENSATION _ PER OTH-
AND EMPLOYERS'LIABILITY Y/N
STATUTE I ER
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH)If yes,describe under E.L.DISEASE-EA EMPLOYE $
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required)
If required by written contract,or written agreement,the Certificate Holder is included as Additional Insured for ongoing operations.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Fort Collins Utility THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
700 Wood Street ACCORDANCE WITH THE POLICY PROVISIONS.
Fort Collins,CO 80521
AUTHORIZED REPRESENTATIVE
ACORD 25(2016/03) 01988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD