HomeMy WebLinkAboutDOWNTOWN BUSINESS ASSOCIATION - INSURANCE CERTIFICATE (18)F ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
TM 0511012005
PRODUCER IBIS GEKIIFIGATE IN ISSUED AS A MATTER OF INFORMATION
Brayton Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
315 West Oak, Suite 710 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. 0. Box 1488
Fort Collins CO 80522 INSURERS AFFORDING COVERAGE NAIC #
INSURED Downtown Business Association INSURER A: Western Heritage Insurance Company
19 Old Town Square INSURER B. Farmers Alliance Insurance Company
Suite 230 INSURER C:
Fort Collins CO 80524 INSURER D:
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.
INSR
ADO'L
F OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDDIYYI
POLICY EXPIRATIONINARn
DATE IMM1DDtYYI
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
SCP 0550214
05101/2005
05101/5006
DAMAGE TO RENTED
$ 100 fit)
CLAIMS MADE 11:1 OCCUR
MED EXP An one rson
$ 5,000
PERSONAL &ADV INJURY
$ 1.000,000
GENERAL AGGREGATE
$ 2,000,030
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ Included
POLICY PRO- LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
1,000,Q00
B
ANY AUTO
CCP 020056
12/23/2004
1212312005
(Ea accident)
s
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY. AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
WC STATUDRYLjjMT,- JOTH-
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - FA EMPLOYE
$
OFFICER/MEMBER EXCLUDED?
Wdescribe under
CIAL PROVISIONS belm
E.L. DISEASE - POLICY LIMIT
$
OTHER
A
Liquor Liability
SCP0550214
0510112005
0510112006
1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is named as an additional insured as their interest may appear with reference to the named insured's operations
Old Town Car Show-06-04-2005
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
SHOULDANYOFTHEABOVEDESCRISEDPOLICIESBECANCELLEDBEFORETHEEXPIRATION
PO BOX 580
DATE THEREOF,THE ISSUING INSURERWILL ENDEAVORTO MAIL 10 DAYSWRITTEN
NOTICETO THECERTIFICATEHOLDERNAMED TO THE LEFT, BUT FAILURETO DO SO SHALL
Fort Collins, CO 80522
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTAT
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ACORD 25 (2001108) 1 F%-- v /9) WORD C-OW-ORAMOU1988