HomeMy WebLinkAboutCOLORADO CARRIAGE - INSURANCE CERTIFICATEJTILUS INSURANCE COMPANY
ZAL LIABILITY COVERAGE PART DECLARATIONS
Effective Date:November 30, 2007 12:01 A.M. Standard Time
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❑ If box is checked, refer to form S132 for Limits of Insurance.
INSURANCE
(Other Than Products/Completed Operations) $ 2,QQQ,Q09.00
og�lAggregateLlmlt
mpteled Operations Aggregate Limit $ Included
fCr
r$it= $ 1.000 000 00 Any One Person or Organization
Advertising Injury Limit
is tl land
$ 1,000 000.00
Qccurrence:Limit
To Prernises Rented To You Limit $ 100.000.00 Any one Premises
g)a rna9 $ 5,000 00 Any One Person
ense Limit
A4�1Ical%xp
ETROA�TIVE DATE (CG 00 02 ONLY)
Thisinsurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" which occurs
t
before the Retroactive Date, If any, shown here: NONE (Enter Date or "NONE" if no Retroactive Date applies)
,—BUSINESS DESCRIPTION AND LOCATION OF PREMISES
�SUSINESSDESCRIPTION: HORSE & CARRIAGE FOR HIRE
LOCATION OF ALL PREMISES YOU OWN RENT, OR OCCUPY: Location address is same as mailing address.
1 410 Franklin St., Fort Collins, CO 80521
2
i Additional locations (if any) will be shown on form S170.
`LOCATION OF JOB SITE (If Designated Projects are to be Scheduled):
I'
f-`—
CODE # -
CLASSIFICATION
PREMIUM
RATE
PREMIUM
BASIS_
PR/CO All Other
_
� 90503 -
Carriage Rides
_
U) 2
316,0000
632.00
Ad
U) 1
250,0000
250.00
* PREMIUM BASIS SYMBOLS + = products/Completed Operations are subject to the General Aggregate Limit
a = Area (per 1,000 sq. ft. of area) o = Total Operating Expenses s = Gross Sales (per $1,000 of Gross Sales)
'c = Total Cost (per $1,000 of Total Cost) (per $1,000 Total Operating Expenditures) t = See Classification
on = Admissions (per 1,000 Admissions) p = Payroll (per $1,000 of payroll) u = Units (per unit)
$ 882.00
FORMS AND ENDORSEMENTS (other than applicable Forms and Endorsements shown elsewhere in the policy)
Forms and Endorsements applying to this Coverage Part and made part of this policy at time of issue:
Refer to S902GL (01/03) Schedule of Forms and Endorsements - General Liability
THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD.
Includes copyrighted material of Insurance Services Office, Inc. with its permission.
Copyright ISO Properties, Inc., 2000
S150 (10/04)
POLICY NUMBER: NC723289
COMMERCIAL GENERAL LIABILITY
CG 20 12 07 98
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED -
STATE OR POLITICAL SUBDIVISIONS - PERMITS
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
SCHEDULE
State Or Political Subdivision:
CITY OF FORT COLLINS
215 N. MIASON
FT. COLLINS, CO 80524
(if no entry appears above, information required to complete this endorsement will be shown in the Declarations
as applicable to this endorsement.)
Section II — Who Is An Insured is amended to
include as an insured any state or political subdivi-
sion shown in the Schedule, subject to the following
provisions:
1. This insurance applies only with respect to'op-
erations performed by you or on your behalf for
which the state or political subdivision has issued
a permit.
2. This insurance does not apply to:
a. "Bodily injury," "property damage' or
"personal and advertising injury" arising out
of operations performed for the state or mu-
nicipality; or
b. 'Bodily injury" or "property damage" included
within the "products -completed operations
hazard".
CG 20 12 07 98 Copyright, Insurance Services Office, Inc., 1997
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