HomeMy WebLinkAbout101359 EVERGREEN TENNIS COURTS INC - INSURANCE CERTIFICATEACORD TM CERTIFICATE OF LIABILITY INSURANCE DATE 7/16/2008
PRODUCER
Heritage General Agency, Inc.
9250 E. Costilla Avenue, Suite 650
Englewood CO 80112
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
Evergreen Tennis Courts & Fences By
Evergreen, Evergreen Tennis Courts, Inc. dba
2332 Fountain Avenue
Loveland, CO 80538
INSURER A: Scottsdale Insurance Company
INSURER B:
NSURER C:
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 WITI"I 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
Lm
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MMIDD/YY)
POLICYEXPIRATION
DATE (MMIDDNY)
LIMITS
A
X
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE DOCCUR
CLS1508890
07/15/2008
07/15/2009
EACH OCCURENCE
$1,000,000
_LAMAUr'r717MTr_
PREMISES(Ea occurrence)
$100,000
MF:D EXP (Any one person)
$5,000
PERSONAL B ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GL AGGREGATE LIMIT APPLIES PER
PRO-
XEN'POLICY JECI' LOC
PRODUCTS -COMP/
OPS AGG
$2,000,000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPER I DAMAGE
(Per accitlent)
GARAGE LIABILITY
ANYAUTO
AUTO ONLY -EA ACCIDENT
OTHER THAN EA ACC
AUTO ONLY: AGO
EXCESS LIABILITY
OCCUR MCLAIMS MADE"
DEDUCTIBLE
RETENTION
EACH OCCURENCE
AGGREGATE
WORKERS COMPENSATION AND
EMPLOYERSLIABILITY
ANY PROPRIETORIPARTNERSHIP/EXECUTIVE
OFFICERME SER EXCLUDED?
If yes, Describe under:
SPECIAL PROVISIONS bel.
IWO DFAT IYXITSI 10 HER
E.L. IiACI I ACCIDENT
CJ_ DISEASE EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
OTHER
DESCRIPTION OF OPERA I-IONS/LOCATIONSNEHICUr SBFXCLUSIONS ADDED BY ENDORSEMENT/SPECIAI. PROVISIONS
Painting and Repair of Tennis Courts; Fence Erection Contractors
Certificate holder is additional insured.
10-day notice for non-payment
CERTIFICATE HOLDER: CANCELLATION
City of Fort Collins
P O Box 580
Fort Collins CO 80522-0580
OULD ANY OF THE ABOVE DESCRi BED POLICIES BE CANCELLED BEFORE THE
>IRAT ION DATE THEREOF, I I IE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TOTHE IE CER rIFICA TE HOLDER NAMED TO THE
I, BUT FAILURE TO DO SO SHALL, IMPOSE NO OBLIGATION OR LIABILITY
ANY KIND UPON TIIE INSURER, ITS AGENTS OR REPRESENTATIVES.
25S(2001108)
REPRESENTATIVE
"I. _1V A
IUYIaQ OEMIN
If the certificate holder is an ADDITIONAL INSURED, the policy(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).
The Certificate of Insurance on the attached or 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 coverage afforded by the policy(ies) listed thereon.
AGENT:
L. A. Olson Agency, Inc.
200 E. 7th Street #120
Loveland CO 80537
PHONE:
970-669-9025
FAX:
970-669-9032
AOORD zss (200110a)