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HomeMy WebLinkAboutLodgepole Capital Ventures, LLC - INSURANCE CERTIFICATE Client#: 180844 LODGCAP
ACORD.. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY)
7/16/2024
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOE*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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER CONTACT
Denise Leeper
CBIZ P&C Adventure Sports AIC,Ne Ell:208 298-3806 FAX NO, 208 748-9433
1504 8th St E-MAIL DLeeper@cbiz.com ADDRESS: p @Cbiz.com
Lewiston,ID 83501
INSURER(S)AFFORDING COVERAGE NAIC#
208 743-9426 INSURER A:Markel Insurance Company 38970
INSURED Lodgepote Capital Ventures, LLC; INSURER B;Artisan and Trumi 3 Gamy company 10194
dba Rocky Mountain Adventures INSURER C
PO Box 1989 INSURER D:
Fort Collins, CO 80522 INSURERE:
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 CONTRACTOR 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 AD SUER
LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER fdMIDDY EFF POLICY EXP LIMITS
A X COMMERCIAL GENERAL LIABILITY X MKP0000501450200 7/25/2024 11/01/2024 EACH OCCURRENCE $1 00U 000
CLAIMS-MADE FXI OCCUR
OPREMIS S Eaoccurrence $300 000
MED EXP(Any one person) $
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY—1 JJECOT I LOC PRODUCTS-COMP/OP AGG $2,000,000
OTHER: $
B AUTOMOBILE LIABILITY 00623997 4/17/2024 10117/2024 Ee BINEDtSINGLE LIMIT $1,000,000
ANY AUTO BODILY INJURY(Per person) $
AWNED
UTOS ONLY X SCHEDULED
AUTOS BODILY INJURY(Per accident) $
HIRED NON-OWNED PROPERTY DAMAGE
AUTOS ONLY AUTOS ONLY Per accident $
A UMBRELLA LIAB OCCUR MKX0000501450300 7/25/2024 11/01/202 EACH OCCURRENCE $1 00U 000
EXCESS LIAB CLAIMS-MADE AGGREGATE $1 00O 000
DED RETENTION$ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N
OFFICERIMEMBER EXCLUDED? ❑ N/A E.L.EACH ACCIDENT $
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
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)
It is understood and agreed that the Certificate Holder is named as
additional insured,but only with respect to its liability arising out of
the activities of the Named Insured.
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
Fort Collins,CO 80522 AUTHORIZED REPRESENTATIVE
CBIZ Insurance Services,Inc.
©1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S4157887/M4157881 WDL
Client#: 180844 LODGCAP
DATE(MM1DD/YYYY)
ACORD- CERTIFICATE OF LIABILITY INSURANCE 1 7/31/2023
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 any rights to the certificate holder in lieu of such endorsement(s).
PRODUCER NAME: Denise Leeper
CBIZ P&C Adventure Sports PHONEo
208 298-3806 Fa,No): 208 748-9433
N Ext AI C
1504 8th St E-MAIL ADDRESS: dleep er cbiz.com
Lewiston, ID 83501 INSURER(S)AFFORDING COVERAGE NAIC#
208 743-9426 Markel Insurance Company 38970
INSURER A: P Y
INSURED INSURER B:Progressive Casualty Insurance Co. 24260
Lodgepole Capital Ventures,LLC; INSURERC:
dba Rocky Mountain Adventures
INSURER D
PO Box 1989
Fort Collins,CO 80522 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 CONTRACTOR 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.
LT R TYpE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
LTR IN SR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
A X COMMERCIAL GENERAL LIABILITY X MKP0000500983700 7/25/2023 07/25/2024 EACH OCCURRENCE $1 000 000
CLAIMS-MADE �OCCUR PREMISES(E.occurr nce 000,000
MED EXP(Any one person) $
PERSONAL&ADV INJURY $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
POLICY JECT LOC PRODUCTS-COMP/OPAGG 52,000,000
OTHER: S
B AUTOMOBILE LIABILITY 00623997 4/17/2023 10/17/2023 COMBINED SINGLE LIMIT
Ea accident S1,000,000
ANY AUTO BODILY INJURY(Per person) S
OWNED X SCHEDULED BODILY INJURY(Per accident) S
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
5
A UMBRELLA LIAB OCCUR MKX0000500984100 7/25/2023 07/25/2024 EACH OCCURRENCE $1 00O 000
EXCESS LIAB HCLAIMS-MADE AGGREGATE $1 000 000
DED I X RETENTION$10000 $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required)
It is understood and agreed that the Certificate Holder is named as
additional insured, but only with respect to its liability arising out of
the activities of the Named Insured.
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Purchasing Division ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 580
Fort Collins,CO 80522 AUTHORIZED REPRESENTATIVE
CBIZ Insumce Seryices,Inc.
©1988-2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S3642890/M3642886 WDL