HomeMy WebLinkAboutLEISURE TIME ASSOCIATES - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE aT DATE (MNVDDfYY
LEISUSU-1 d 04 28 04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Talty ,Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1720 S. Bellaire St. #801 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver CO 80222
Phone:303-756-7755 Fax:303-756-7781 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Allied Insurance Company
INSURERS:
Leisure Time Associates, Inc. INSURERc:
10298 West Lay ton Place INSURERD:
Littleton CO 80127
INSURER E:
COVFRArFS
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATE MM/DDfYY
DATE MMIDDIYY RATION
LIMITS
A
GENERAL LIABILITY
X COMMERCIALGENERAL LIABILITY
CLAIMS MADE X❑ OCCUR
ACP7560063883
04/01/04
04/01/05
EACH OCCURRENCE
$ 1, 000, 000
PREMISES (Ea occurence)
$100,000
MED EXP (Any one person)
$ 5,000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECT LOC
PRODUCTS - COMP/OP AGG
s2,000,000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEOULED AUTOS
HIRED AUTOS
NON-OWNEDAUTOS
ACP7560063883
04/01/04
04/01/05
COMBINED SINGLE LIMIT
(Ea accident)
$500,000
X
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESSIUMBRELLA LIABILITY
OCCUR CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
$
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOWPARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
TORY LIMITS I I ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEEI
$
E.L. DISEASE - POLICY LIMIT is
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
a cm r rrna. i c nvLUCK UANULLLATION
CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City Of Fort Collins NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
James O'Neill II
Dir. of Purchasing & Risk Mgmt IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
PO BOX 580 REPRESENTATIVES.
Fort Collins CO 80522 AUTjVRIZED REPRESFN7 1VE
ACORD 25 (2001/08) 0 ACORD