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HomeMy WebLinkAboutKEN, LINDA & BRIAN FISHER - INSURANCE CERTIFICATEOP ID: DS ,A14 R CERTIFICATE OF LIABILITY INSURANCE D AT04/13111 wl 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 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 endorsements . 970-867-8246 Goetz Insurors, Inc. 5 970-66 227 Main St 7-0406 Fort Morgan, CO 80701 Tracy A. Parachini CONTACT NAMEPRODUCER - PNONE FAX A/C No Eat), A/C No): E-MAIL ADDRESS:PRODUCER CUSTOMER ID, FISH-KE - INSURERS AFFORDING COVERAGE NAIC k INSURED Ken, Linda & Brian Fisher Kenlyn Stables, Inc 4916 Bingham Hill Rd Fort Collins, CO 80521-1073 INSURERA:American Bankers Insurance Co INSURERB:American Reliable Insurance Co 19615 INSURER C: INSURER 0 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MMIDDM P LI Y EXP MMIDD/YY1'Y LIMITS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY. CLAIMS -MADE OCCUR X FSL4160697 11120110 11/20/11 EACH OCCURRENCE $ 1,000,00 PREMISES Es occurrence $ SQ 00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY PRO LOC PRODUCTS AGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS - COMBINED SINGLE LIMIT (Es accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccident) $ $ $ UMBRELLA LIAR EXCESS LIAR CLAIMS -MADE EACH OCCURRENCE $ HOCCUR AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERNEMBER EXCLUDED? (Mandatory in NH) yes, doscno. under DESCRIPTION OF OPERATIONS below NIA WC STATU. OTH- E. L. EACH ACCIDENT $ E.L DISEABE-EAEMPLOYEE 8 E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) Certificate holder is additional insured in respect to hay operation. Additional insured includes The City, its officers, agents and employees. The City of Fort Collins Purchasing Department PO Box 580 Fort Collins, CO 80522-0580 FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. %-\ AUTHORIZED REPRESENT) Tracy A. Parachini ACORD 25 (2009/09) © 1988-2009 ACORD The ACORD name and logo are registered marks of ACORD All rights reserved. OP ID: DS ,A14 R CERTIFICATE OF LIABILITY INSURANCE D AT04/13111 wl 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 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 endorsements . 970-867-8246 Goetz Insurors, Inc. 5 970-66 227 Main St 7-0406 Fort Morgan, CO 80701 Tracy A. Parachini CONTACT NAMEPRODUCER - PNONE FAX A/C No Eat), A/C No): E-MAIL ADDRESS:PRODUCER CUSTOMER ID, FISH-KE - INSURERS AFFORDING COVERAGE NAIC k INSURED Ken, Linda & Brian Fisher Kenlyn Stables, Inc 4916 Bingham Hill Rd Fort Collins, CO 80521-1073 INSURERA:American Bankers Insurance Co INSURERB:American Reliable Insurance Co 19615 INSURER C: INSURER 0 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MMIDDM P LI Y EXP MMIDD/YY1'Y LIMITS GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY. CLAIMS -MADE OCCUR X FSL4160697 11120110 11/20/11 EACH OCCURRENCE $ 1,000,00 PREMISES Es occurrence $ SQ 00 MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY PRO LOC PRODUCTS AGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIREDAUTOS NON -OWNED AUTOS - COMBINED SINGLE LIMIT (Es accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Peraccident) $ $ $ UMBRELLA LIAR EXCESS LIAR CLAIMS -MADE EACH OCCURRENCE $ HOCCUR AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECUTIVE OFFICERNEMBER EXCLUDED? (Mandatory in NH) yes, doscno. under DESCRIPTION OF OPERATIONS below NIA WC STATU. OTH- E. L. EACH ACCIDENT $ E.L DISEABE-EAEMPLOYEE 8 E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more apace Is required) Certificate holder is additional insured in respect to hay operation. Additional insured includes The City, its officers, agents and employees. The City of Fort Collins Purchasing Department PO Box 580 Fort Collins, CO 80522-0580 FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. %-\ AUTHORIZED REPRESENT) Tracy A. Parachini ACORD 25 (2009/09) © 1988-2009 ACORD The ACORD name and logo are registered marks of ACORD All rights reserved.