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HomeMy WebLinkAbout375496 PAWNEE SPORTSMENS CENTER LLC - INSURANCE CERTIFICATE (2)ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (BIM OD DOS 03/13/zoos PRODUCER (303) 773-9999 FAX (303) 773-9776 Arthur J Gallagher Risk Management Services, Inc 6399 S Fiddlers Green Circle #200 Attn Anita Bruner Greenwood Village, CO 80111 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 BELOW INSURERS AFFORDING COVERAGE NAIC# INSURED City of Fort Collins P 0 Box S80 Fort Collins, CO 80522 INSURERA Princeton AS INSURER INSURER INSURER D INSURER E 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 DD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATON LIMITS GENERAL LIABILITY N1A3RL000004800 04/15/2007 04/15/2008 EACH OCCURRENCE $ 500,000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE occuR [X COV A - GEN LIAB AUTO LIAB LEL LIAB DAMAGE TO RENTED $ MED EXP (Any one person) $ A x X SIR $500,000 per OV B PUBLIC OFFICIALS PERSONAL S ADV INJURY B occurrence GENERAL AGGREGATE $ 500,00 LIABILITY GENIAGGREGATE LIMIT APPLIES PER POLICY ZF& LOC PRODUCTS COMP/OPAGG S AUTOMOBILE LIABILITY ANY AUTO COMBINED (Ee awdent8lNGLE LIMIT S ALL OWNED AUTOS SCHEDULEDAUTOS BODILYINJURY (Per Pereen) $ HIREDAUTOS NON-0WNEDAUTOS BODIW INJURY (Pere denl) S PROPERTY DAMAGE (Per eccMenl) S GARAGELIABILITY AUTOONLY EAACCIDENT $ ANY AUTO OTHER THAN EA ACC AUTO ONLY AGG $ $ A x EXCESSUMBRELLA LIABILITY X OCCUR CLAIMS WOE N1A3F0000000600 04/15/2007 04/15/2009 EACH OCCURRENCE 6 2,500,00 AGGREGATE $ $ s soo 00 DEDUCTIBLE 4 RETENTION $ $ WORKERS COMPENSATION AND EMPLOVERS' LIABILITY WCSTATU OW- EL EACH ACCIDENT $ ANY PROPRIETOMPARTNEIVEXECUTIVE OFFICERINEMSER EXCLUDED? U yea dexdbe uMer SPECIAL PROVISIONS beb EL DIBEASE EA EMPLOYE S EL DISFASE POLICY LIMIT S OTHER DES:RIPTIONOFOPERAnONSILOCATIOMIVENICLESIEXCL lo."ADD BY ENDORSEMENT/ SPECIAL PROVISIONS ertificate Holder is included as ad�itionaTl insured as respects general liability coverage as required y their written contract with the named insured in Exhibit A Scope of Work, the agreement between ity of Fort Collins Police Services and Pawnee Sportsmens Center LLC for use of Outdoor Shooting anges and Clubhouse space from Jahuary 1, 2008 through December 31, 2009 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL Pawnee Sportsmens Center LLC 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT Attn Richard Beck BUT FAILURE TO MAIL SUCH NOTICE$HALL IMPOSE NO OBLIGATION OR LIABILITY 41132 Weld County Rd #13 OF ANY KIND UPON THE INSURER ITS AGENTS OR REPRESENTATIVES Fort Collins, CO 80S24 AUTHORRED REPRESENTATIVE Karen Graha AGGRO 25 (2001108) ©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED the poticy(ies) must be endorsed A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) 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 endorsement(s) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s) authorized representative or producer and the certificate holder nor does it affirmatively or negatively amend extend or alter the coverage afforded by the policies listed thereon —+ . aV I'vV IIvol