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Home My WebLink AboutTHE JENSEN INVESTMENT GROUP - INSURANCE CERTIFICATE? SHELTER INSURANCE COMPANIES IIIIIIIIIIII IIIIIII ME a THIS POLICY ISSUED BY: AGEIIIIIIIIII SHELTER MUTUAL INSURANCE CO. GENERAL LIABILITY POLICY LINDSAY MORALES o DECLARATIONS STE C ADDITIONAL INSURED COPY 220 W PROSPECT RD FORT COLLINS, CO 80526 970-484-7505 05-OE110-01 ' NAME AND ADDRESS OF INSURED: REISSUE OF POLICY NUMBER 05-31-003561297-0003 THESE DECLARATIONS ARE A PART OF YOUR POLICY POLICY AND ENDORSEMENTS ARE AVAILABLE UPON REQUEST IIu lillunlrin lullrl lln lrl Ili II rl rlrlu urlr nilr r r url r THE JENSEN INVESTMENT GROUP LLC % MICHAEL JENSEN 1220 S COLLEGE AVE FORT COLLINS CO 80524-3716 POLICY PERIOD: FROM 12:38 P.M. SEPTEMBER 17, 2008 TO JULY 8, 2009 AT 12:01 A.M. STANDARD TIME AT THE LOCATION OF THE PROPERTY DESCRIBED, AND SUBJECT TO CONSENT OF THE COMPANY FOR TERMS OF SUCH DURATION EACH THEREAFTER AS THE REQUIRED RENEWAL PREMIUM IS PAID BY THE INSURED AND RECEIVED BY THE COMPANY ON OR BEFORE EXPIRATION OF THE CURRENT TERM. LOCATION OF THE PREMISES COVERED IS: DEFINED POLICY TERRITORY OR SEE BELOW BUSINESS OF THE NAMED INSURED IS: DWELLINGS THE NAMED INSURED IS: OTHER AUDIT PERIOD: N/A SUBJECT TO THE TERMS OF THIS POLICY, THE COMPANY'S LIMITS OF LIABILITY FOR THE COVERAGES PROVIDED UNDER THIS POLICY ARE AS FOLLOWS: I LIMITS OF INSURANCE I I GENERAL AGGREGATE (OTHER THAN PRODUCTS - COMPLETED OPERATIONS) S 1,000,000 I I PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT (SEE EACH CLASSIFICATION BELOW) INCLUDED I I PERSONAL AND ADVERTISING INJURY LIMIT 5 500,000 I 1 EACH OCCURRENCE LIMIT 5 500,000 I I RENTED TO YOU LIMIT 5 100,000 ANY ONE PREMISESI ICG-00-01 COMPREHENSIVE GENERAL LIABILITY I I (ANNUAL) I 1PREMISE3 8 OPERATIONS- I I 1 163010 DWELLINGS - ONE FAMILY (LESSORS RISK ONLY) I EACH I 33.211 1 33.00 1 INCLUDING PRODUCTS 8/OR COMPLETED OPERATIONS I 1 I I I ITEM ZIP CODE: 80524 I I I 1 1019 1/2 CLUB VIEW RD FORT COLLINS CO I I I (PREMISES 8 OPERATIONS- I I I 163011 DWELLINGS - TWO FAMILY (LESSORS RISK ONLY) I EACH i 35.137 1 35.00 1 INCLUDING PRODUCTS 8/OR COMPLETED OPERATIONS I 1 ( I I ITEM ZIP CODE: 80524 I I 1 1 1203 REMINGTON ST FORT COLLINS CO I I I (PREMISES 8 OPERATIONS- I I I 163010 DWELLINGS - ONE FAMILY (LESSORS RISK ONLY) I EACH 1 33.211 1 33.00 1 INCLUDING PRODUCTS 8/OR COMPLETED OPERATIONS I 1 I 1 I ITEM ZIP CODE: 80524 I I I 1 211 WHEDBEE ST FORT COLLINS CO I I I [PREMISES 8 OPERATIONS- I I I ***SEE CONTINUATION PAGE*** A POLICY CONSISTS OF THIS DECLARATION, COMMON POLICY I CONDITIONS AND ONE OR MORE COVERAGE FORMS. A COVERAGE PART I CONSISTS OF A COVERAGE FORM AND APPLICABLE ENDORSEMENTS. I ADDL INSURED: #003561297 CITY OF FORT COLLINS PO BOX 580 FORT COLLINS CO 80522-0580 TRANSACTION: PC SL H. 0. CODE: 672.00 POLICY TERM: ONE YEAR DATE ISSUED: 10-24-2008 '07102008' ADOL INSURED: #003561297 DOWNTOWN DEVELOPMENT AUTHORITY 19 OLD TOWN SQUARE STE 230 FORT COLLINS CO 80524-2471 ILJJIrrrrlJrrrLlrrLlllrrrrlrLlrrl,IlrrrlrrLllrrrrrlril COUNTERSIGNED BY G-2.8-G PAGE 1 1817 WEST BROADWAY • COLUMBIA, MISSOURI 65218-0001 (573)445-8441 lSHELTER INSURANCE COMPANIES DECLARATIONS --CONTINUATION PAGE --POLICY NUMBER 05�31-003561297-0003 AGENT: 05-DE110-01 INSURED: THE JENSEN INVESTMENT GROUP ISSUE DATE: 10-24-2008 160010 APARTMENT BUILDINGS I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80524 I 813 SCOTT ST FT COLLINS CO (PREMISES 8 OPERATIONS- 163010 DWELLINGS - ONE FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS 1 ITEM ZIP CODE: 80549 I 3528 W CLEVELAND AVE WELLINGTON CO (PREMISES 8 OPERA'FIONS- 163010 DWELLINGS - ONE FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80524 I 701 REMINGTON ST FORT COLLINS CO (PREMISES & OPERATIONS- 163011 DWELLINGS - TWO FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80524 1 1019 CLUB VIEW RD FORT COLLINS CO [PRFMISES & OPERATIONS- 163011 DWELLINGS - TWO FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS 1 ITEM ZIP CODE: 80524 I 511 W MYRTLE ST FORT COLLINS CO [PREMISES & OPERATIONS- 163010 DWELLINGS - ONE FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80524 601 S SHERWOOD ST FORT COLLINS CO (PREMISES 8 OPERATIONS- 163013 DWELLINGS - I FOUR FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS 9/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80521 I 809 SCOTT AVE FORT COLLINS CO (PREMISES & OPERATIONS- 163013 DWELLINGS - I FOUR FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80524 I 1201. W PLUM ST FORT COLLINS CO (PREMISES 8 OPERATIONS- 163010 DWELLINGS - ONE FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 60524 I 1928 SPRINGFIELD OR FORT COLLINS CO [PREMISES & OPERATIONS- 163011 DWELLINGS - TWO FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80524 I 705 REMINGTON ST FORT COLLINS CO (PREMISES & OPF.RATIONS- 163010 DWELLINGS - ONE FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80524 I 404 E OAK ST FORT COLLINS CO (PREMISES 8 OPERATIONS- 163010 DWELLINGS - ONE FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS 8/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80521 I 1310 LAPORTE AVE FORT COLLINS CO (PREMISES 8 OPERATIONS- 163010 DWELLINGS - ONE FAMILY (LESSORS RISK ONLY) I INCLUDING PRODUCTS &/OR COMPLETED OPERATIONS I ITEM ZIP CODE: 80524 I 704 REMINGTON ST FORT COLLINS CO I I UNITS I 8 1 I I EACH I 1 i i I EACH I 1 I I I I EACH I 1 I I I I EACH I 1 I I I EACH i 1 1 I I EACH I 1 I 15.715 ( I I I I 126.00 I I I I I 33.211 I I I I I 33.00 I I I I I 33.211 I I I I I 33.00 I I I I I 35.137 I I I 1 I 35.00 I I I I I 35.137 1 I I I I 35.00 I I I I I 33.211 I I I I I 33.00 I I I I I 54.116 I I I I I I I I 54.00 EACH 1 54.116 1 54.00 1 I I I I I I I I ( I EACH I 33.211 1 33.00 1 I I I I EACH I 35.137 I 35,00 1 I I I I EACH I 33.211 I 33.00 1 I 1 EACH 1 EACH 1 I i I I 33.211 I 33.00 I I I I I I I I 33.211 1 33.00 I I I CG-0001 (1.2-2007) COMMERCIAL GENERAL LIABILITY COVERAGE FORM CG-21-67 (12-2004) FUNGI OR BACTERIA EXCLUSION I I_ I I I B-412-B PAGE 2 1817 WEST BROADWAY • COLUMBIA, MISSOURI 65218-0001 • (573)445-8441 low, SHELTER INSURANCE COMPANIES I II III IIIIIIIIIIIIIIIII III II DECLARATIONS --CONTINUATION PAGE --POLICY NUMBER 05-31-003561297-0003 AGENT: 05-OE110-01 INSURED: THE JENSEN INVESTMENT GROUP ISSUE DATE: 10-24-2008 ICOVERAGE FORM AND DESCRIPTION OF HAZARDS I PREMIUM BASES I RATES I ADVANCE PREMIUM CG-20-10 (07-2004) ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) DOWNTOWN DEVELOPMENT AUTHORITY G-146-G POLLUTION LIABILITY COVERAGE IL-02-28 (09-2007) COLORADO CHANGES - CANCELLATION AND NONRENEW IL-00-17 (11-1998) COMMON POLICY CONDITIONS CC-21-44 (07-1998) LIMITATION OF COVERAGE TO DESIGNATED PREMISES OR PROJECTS DESCRIBED PREMISES CG-21-60 (09-1998) EXCLUSION - YEAR 2000 COMPUTER -RELATED & ELECTRONIC PROBLEMS CG-20-10 (07-2004) ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS (FORM B) CITY OF FORT COLLINS G-252-G AMENDATORY ENDORSEMENT CG-24-01 (12-2004) NON -BINDING ARBITRATION CG-21-47 (12-2007) EMPLOYMENT -RELATED PRACTICES EXCLUSION 8-601-8 LEAD POISONING EXCLUSION ENDORSEMENT B-559-B ASBESTOS EXCLUSION B-412-B PAGE 3 1817 WEST BROADWAY • COLUMBIA, MISSOURI 65218-0001 • (573)445-8441 THIS PAGE INTENTIONALLY LEFT BLANK Page 4