HomeMy WebLinkAboutLEWIS TENNIS LLC - INSURANCE CERTIFICATEFm:Ewing-Leavitt Insurance To:ATTN: James O'Neill (19702216707) 08:53 07128109GMT-06 Fig 02-03
ACORP CERTIFICATE OF LIABILITY INSURANCEDATE
06/26/Z1009)
PRODUCER (970)679-7333 FAX (866)456-4265
Ewing -Leavitt Insurance Agency
4025 St. Cloud Dr.
Suite 100
Loveland, CO 80538
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 Lewis Tennis LLC
1205 W Elizabeth ST. #PM13111
Fort Collins, CO 80521
INSURERA Auto Owners
18988
INSURER B.
INSURER
INSURER D.
INSURER E
rnVFRAGFS
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 EXPIRATION
LIMITS
GENERAL LIABILITY
7468736808
07/15/2009
07/15/2010
EACH OCCURRENCE
$ 1,000,00
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO RENTED
$ 50,0 �
CLAIMS MADE M OCCUR
ME D FXP (Any one perscn)
$ 5,00
A
PERSONAL & ADV INJURY
$ 1,00000
GENERAL AGGREGATE
S 2,000,00
GEN'L AGGREGATE LIMIT APPLIES PER.
PRODUCTS - COMP/OP AGG
$ 2,000,000
X POLICY 7 PROJECT LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
$
ANY AUTO
(Ed accident)
BODILY INJURY
ALL OWNED AUTOS
SCHEDULED AUTOS
(Per person)
$
BODILY INJURY
$
HIRED AUTOS
NOWOW NEU AU I US
(Por accidont)
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
S
ANY AUTO
S
AUTO ONLY. AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
S
$
DEDUCTIBLE
S
RETENTION $
WORKERS COMPENSATION AND
TH-
Y
OR STATUS MITS FIR
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
ANY PROPRIETORrPARTNERIEXECUTNE
E L DISEASE - EA EMPLOYEE
$
OFFICERIMEMBER EXCLUDED
It yes, describe under
E.L. DISEASE - POLICY LIMB 1
$
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES I EXC USIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
erti icate holder is an Additiona Insured.
City of Fort Collins
PO Box 580
Fort Collins, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
ACORD 25 (2001108) FAX: (970)221-6707 OACORO CORPORATION 1988
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Fm:Ewing-Leavitt Insurance To:ATTN: James O'Neill (19702216707) 08:53 07/28109GMT-06 Pg 03-03
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.
ACORD 25 (2001/08)
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