HomeMy WebLinkAboutARROWHEAD TRAILS INC - INSURANCE CERTIFICATE (2)CERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company ❑
American Family Mutual Insurance Company it selection box is not checked
6000 American Pky Madison, Wisconsin 53783-0001
Insured's Name and Address Agent's Name, Address and Phone Number (Agt./Dist.)
Arrowhead Trails Inc Lonnie David (303) 451-1579
11121 County Rd 240 2770 Dagny Way Ste 116
Salida, CO 81201 Lafayette, CO 80026-8013 (065/311)
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 listed below.
COVERAGES
This is to certify that 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 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.
TYPE OF INSURANCE
POLICY NUMBER
POLICY DATE
LIMITS OF LIABILITY
EFFECTIVE EXPIRATION
Mo Dav, Yr Mo Day, Yr
Homeowners/
Bodily Injury and Property Damage
Mobilehomeowners Liability
Each Occurrence $ ,000
Boatowners Liability
Bodily Injury and Property Damage
Each Occurrence $ ,000
Personal Umbrella Liability
Bodily Injury and Property Damage
Each Occurrence $ ,000
Farm Liability & Personal Liability
Farm/Ranch Liability
Each occurrence $ 000
Farm Employer's Liability
Each Occurrence $ 000
Workers Compensation and
Statutory :...,:..,...
Each Accident $ 000
Employers Liability t
Disease - Each Employee $ ,000
Disease - Policy Limit $ ,000
General Liability
General Aggregate $ 2,000 000
Products - Completed Operations A re ate $ 2,000 ,000
® Commercial General
Liability (occurrence)
❑
05-X77578-01-00
4/30/2005
4/30/2006
Personal and AdvertisinIn'u $ 1,00D 000
Each Occurrence $ 1,000 ,000
❑
Dame a to Premises Rented to You $ 100 000
Medical Expense (Any One Person) $ 5 000
Businessowners Liability
Each Occurrencet t $ 000
Aggregatett $ ,000
Liquor Liability
Common Cause Limit $ 000
Aggregate Limit $ ,000
Automobile Liability
Bodily Injury - Each Person $ .000
❑ Any Auto
❑ All Owned Autos
Bodily Injury - Each Accident $ 000
❑ Scheduled Autos
Property Damage $
❑ Hired Auto
000
❑ Nonowned Autos
❑
Bodily Injury and Property Damage Combined $ ,000
Excess Liability
❑ Commercial Blanket Excess
Each Occurrence/Aggregate $ 000
❑
�;
Other (Miscellaneous Coveraaes)
Additional Insured: City of Fort Collins
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / RESTRICTIONS / SPECIAL ITEMS t The individual or partners shown as insured ❑ Have ❑ Have not
Landscaper elected to be covered as employees under this policy.
t t Products -Completed Operations aggregate is equal to each
occurrence limit and is included in policy aggregate.
CERTIFICATE HOLDER'S NAME AND ADDRESS
CANCELLATION
• Cityof Fort Collins
LJ Should any of the above described policies be cancelled before the
expiration date thereof, the company will endeavor to mail'( days)
215 N Mason St
written notice to the Certificate Holder named, but failure to mail such
PO Box 580
notice shall impose no obligation or liability of any kind upon the
or representatives. 'TO days different
Fort Collins, CO 80522
number of days seats unless
® This certifies coverage on the date of issue only. The above
described policies are subject to cancellation in conformity with their
terms and by the laws of the state of issue.
DATE ISSUED
I PYTHPIZED
REP RE NTATIVE
5/24/2005
U-201 Ed. 5/00 Certificate Holder Stock No. 06668 Rev. 7/02