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HomeMy WebLinkAboutLEWIS TENNIS - INSURANCE CERTIFICATE (3)AC-ORD CERTIFICATE OF LIABILITY INSURANCE 08/29/20 ) PRODUCER (970)679-7333 FAX (970)679-7377 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATEI HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 100 Loveland, CO 80538 INSURERS AFFORDING COVERAGE NAIC # . INSURED Lewis. Tennis Inc. INSURERA Auto Owners- 18988-I--- 1205W.Elizabeth-ST..#PMB111 INSURERB: - Fort Collins, CO 80521 INSURERc ---- -- --- -�- --_..i- ----- t INSURER D'. . . 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. I I INSR ADD't TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY 7468736807 07/15/2007 07/15/2008 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY UAMAGE TO kENTEU $ 50, DOD CLAIMS MADE M OCCUR MED EXP (Any one person) 8 _ 15,000 A PERSONAL BADVINJURY $ 1,000,000 GENERAL AGGREGA IE $ 2,000,000 GENE AGGREGATE LIMIT APPLIES PER PRODUCTS- COMPIOP AGG $ 2,000,000 JECI X POLICY PRO- LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) $ - - BODILY INJURY $ ' HIRED AUTOS NON-OWNIM AUTOS (Per accident) PROPERTY DAMAGE $ (Per.accident) - GARAGELIABILITY AUTO ONLY - EA ACCIDENT $ — OTHER THAN EAACC $ ANY AUTO $ AUTO ONLY. AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR O CLAIMS MADE AGGREGATE $ $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION AND WC STAT U-I MIT, OTH EMPLOYERS' LIABILITY ANY PROPRIETOkIPAR I NEWEXECUTIVE E.L. EACH ACCIDENT $ C1 DISEASE - EA EMPLOYECi $ OPFICEWMEMBER EXCI. UDED9 It yes, describe under SPECIAL PROVISIONS belt. L.I.. DISEASE -POLICY LIMIT $ OTHER I DESCRIPTION OF OPERATIONS LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS I 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 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LI BUT EPICURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILI OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRE: Brvan Brenni ACORD 25 (2001/OS) FAX: . (970)221-6707 ©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 byi the policies listed thereon. ACORD 25 (2001108)