HomeMy WebLinkAbout102747 JAX OUTDOOR GEAR - INSURANCE CERTIFICATEs*•*e r„aM CERTIFICATE OF INSURANCE
T ih t ® STATE FARM FIRE AND CASUALTY COMPANY, Bloomington, Illinois
❑ STATE FARM GENERAL INSURANCE COMPANY, Bloomington, Illinois
in rf19 'ng p 3licyholder for the coverages indicated below:
ameofpolkyholder Jax, Inc.
Address of pc licyhoklar 1200 N College Ave
Fort Collins CO 80524-1212
Location of of orations
Description o, operations
The policies listed below have been issued to the policyholder for the policy periods shown. The insurance described in these policies is
subi9Ct to all the karma PYPdusir a anra rnnriAinna of Hknna r...l:w:ne The 1:...4-. n-. aa.. .—__. I_.._ I___ -
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
VY WI OIY YIpn11.7.
LIMITS OF'IJABILITY
Effective Data iration Data
at beginning of policy perhA)
Comprehensive
BODILY INJURY AND
96-27-4041-7
Business Liability
12/19/04
12/19/05
PROPERTY DAMAGE
This insurance indude is ® Products - Completed Operations
Contractual Liability
® Underground Hazard Coverage
Each Occurrence $ 1, 000 e 000
® Personal Injury
® Advertising Injury
General Aggregate $ 2, 0 0 0, 0 0 0
❑ Explosion Hazard Coverage
Products - Completed
❑ Collapse Hazard Coverage
Operations Aggregate $ 2 , 0 0 0 , O 0 0
❑ General Aggregate Limit applies to each project
C
EXCESS LIABILITY
POLICY PERIOD
BODILY INJURY AND PROPERTY DAMAGE
Effective Date Expiration Date
(Combined Single Limit)
96—CN-0152-5
Umbrella
Each Occurrence $1,000,000
Other
03 01 05
03/01/06
AquMate
96—G5--9191-0
06/23/04
6/23/05
PartI STATUTORY
Part 2 BODILY INJURY
Workers' Compensation
and Employers Liability
Each Accident $ 10 0 , 0 0 0
Disease Each Employ" $ 100, 000
Disease - Policy Limit $500,000
POLICY NUMBER
TYPE OF INSURANCE
POLICY PERIOD
Effective Dat® Ex iration Date
LIMITS OF ;JABILITY
at be innin oti olio rind
It any of the described policies are canceled before its
expiration date, State Farm will try tq mail a written notice to
the certificate holder 3 0 days pefore cancellation. If,
however, we fail to mail such notice no obligation or liability
will be imposed on State Falm or its agents or
representatives.
Name and Address of i �ertificate Holder
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
Fax # 970-221-6707
660-984 a 2•90 Printed in U 6 A
60 39tid NOS63UNVS 909 96169ZZ0L6 9Z:01 500Z/80/90