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MOUNTAIN STATES TENT AND AWNING - INSURANCE CERTIFICATE
OP ID jt ACORD CERTIFICATE OF LIABILITY INSURANCE MoOPID M/ DATE (MDD/YYYY) 06 03/09 PRODUCER ARA Insurance Services 102 NW Parkway Kansas City MO 64150 Phone: 800-821-6580 Fax:816-474-1931 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 .,, ., i -Mountain—States--Tent & Awning; Mountain States Signs LCC 7-11 -E _Fox.,Farm Rd;. Unit #3 -:- Cheyenne WY 82007-2498 ... i:i..=- .. INSURER A: Praetorian insurance Company, _ 37257- INSURER B: _ INSURERC: INSURERD: INSURER E: COVERAGES` 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. LT7GENERAL TYPE OF INSURANCE POLICY NUMBER POLICY EFFE TIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS AMMERCIAL LIABILITY GENERAL LIABILITY CLAIMS MADE K OCCUR H844900081-05 07/19/09 07/19/10 EACH OCCURRENCE $ 1,000,000 PRE MISES(DAMAGE ")Eaoccurence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PROJECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS .. _ r NON -OWNED AUTOS . H844900082-01 ( 06/13/09 07/19/10 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) X X BODILYINJURY (Per accident) $ X PROPERTY DAMAGE (Per accident) - $ GARAGE LIABILITY ANY AUTO _ AUTO ONLY - EA ACCIDENT - $ OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ - - --ANY WORKERS COMPENSATION AND EMPLOYERS' LIABILITY PROPRIETOWPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below TORY LIMITS ER E.L. EACH ACCIDENT $ -_ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ A OTHER Rental/Sales Inv. All Risks H844900081-05 07/19/09 07/19/10 Blanket DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITOFTC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL CITY OF FT COLLINS IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO BOX 580 REPRESENTATIVES. FT COLLINS CO 80522 AUTHORIZED REPRESENTATIVE ARA Insurance Services ACORD 25 (2001/08) © ACORD CORPORATION 1988 IMPORTANT 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). 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. sACORD 25 (2001/08)