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HomeMy WebLinkAboutLEWIS TENNIS - INSURANCE CERTIFICATE (2)� o • rao nl Ir o0 oano TM IJn• AOA—'MLl ACORQn CERTIFICATE OF LIABILITY INSURANCE 08/z z o PRODUCER (970)679-7333 FAX (970)679-7377 Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. Suite 100 Loveland, CO 80538 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Lewis Tennis Inc. 1205 W Elizabeth ST. #PMB111 Fort Collins, CO 80521 INSURER Auto Owners 18988 INSURER B INSURER INSURER D_ INSURER E rnveoAcoe 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 MAYBE 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. INS RADD' LTRTYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE DATE MMIDD POLICY EXPIRATION DATE IN 0DAP1LIMITS GENERAL LIABILRY 7468736807 07/15/2007 07/15/2008 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 50,00 CLAIMS MADE OCCUR MED EXP(AN one person) $ 5,000 A PERSONAL & ADV INJURY $ 1,000,000, GENERAL AGGREGATE S 2,000,00 GENL AGGREGATE I APPLIES PER. X POLICY JECT LOC PRODUCTS-COMP/OP AGO $ 2,000,00 AUTOMOBILE LIABILITY ANYAUTO COMBINED SINGLE UNIT (EaaCCIdent) $ ALL OWNED AUTOS SCHEDULED AUTOS BOrperson (Per parson) $ HIRED AUTOS NONOWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccidenl) $ GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ ANY AUTO OTHETHAN EAACC $ AUTOONLY. AUTO OAGO $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE 8 RETENT.ON 8 $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY WC STATLL VTH TORV IMITS ER EL.EACHACCIDENT $ ANY PROPRIETORTARTNERIEXECLRIVE OFFICERIMEMBER EXCLUDED? PEC`Ascrlb-,,6or SPECIAL PROVISIONS below EL.DISEASE -EAEMPLOYEE $ ELDISEASE- POLICY LIMIT $ OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENTI SPECIAL PROVISIONS City of Fort Collins Purchasing Department PO Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 GAYS WRITTEN NOTICE TOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE AGVKUZO(ZUU1/U8) rHA: l9l VJLL1—O/V/ ©ACORD CORPORATION 1988 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. AUUKU ZO tZUUI/UU)