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HomeMy WebLinkAboutGROWLING BEAR CO - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE O R DATE (MM/DO YYYY) GROWL -3 06 20 07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LBN Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4848 Thompson Pkwy ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Johnstown CO 80534 Phone:970-635-9400 Fax:970-635-9401 Growling Bear Co., Inc. 2330 4th Ave. Greeley CO 80631 _VvcR "Qa INSURERS AFFORDING COVERAGE NAIC # INSURER A: Employers Mutual INSURER B: Pinnacol Assurance INSURER C: INSURER D: INSURER E: 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. LTRONSRC TYPE OF INSURANCE POLICYNUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY OD96522 07/31/07 07/31/08 PREMISES(Eaoccurance) $100,000 MED EXP (Any one person) $ 5,000 CLAIMS MADE a OCCUR X Blanket Add r 1 PERSONAL $ ADV INJURY $ 1 , 000 , 000 X Blkt Waiver GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000 1-1 POLICY X PRO LOC JECT AUTOMOBILE LIABILITY A ANY AUTO OE96522 07/31/07 07/31/08 COMBINED SINGLE LIMIT CO accident) $1,000,000 X ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS X BODILY INJURY $ X NON -OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ $ AUTO ONLY: AGG EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 4,000,000 A X OCCUR CLAIMS MADE OJ96522 07/31/07 07/31/08 AGGREGATE $4,000,000 DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION AND X TORY LIMITS $ EMPLOYERS' LIABILITY ER ANY PROPRIETOR/PARTNER/EXECUTIVE 1436910 07/01/07 Q7/O1/Q$ E.L. EACH ACCIDENT s500,000 OFFICER/MEMBER EXCLUDED? If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 500 , 000 SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $500, 000 OTHER A Installation OC96522 07/31/07 07/31/08 Any 1 Loc $1,500,000 Floater Ded $500 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ALL Operations - All Locations , =MM 1�11 1Tr CITYFTC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City Of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 215 North Mason REPRESENTATIVES. Fort Collins CO 80525 AU RIZE REPRES T G ACORD 25 (2001/08) ©ACORD CORPORATION 1 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. AGORD 25 (2009IUS)