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RAM INTERNATIONAL 1 INC - INSURANCE CERTIFICATE
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 0/YYYY) 2/1 2/1 M/DD9/10 PRODUCER 1-253-627-7183 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Arthur J. Gallagher Risk Management Services, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 2925 - ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. r- Tacoma, WA 98401-2925 I'. �� I' INSURERS AFFORDING COVERAGE NAIC # INSURED Ram International 1, LLC MAR 2 2010 INSURERA:UNIGARD INS CO 25747 INSURERB:ZURICH INS. CO. 11150 L 10013 - 59th Avenue SW. `INSURERC: INSURERD: Tacoma, WA 98498 I 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. INSRADD" LTR INSR TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE MM DD POLICY EXPIRATION DATE MM DD LIMITS • GENERAL LIABILITY CM012524 05/01/09 05/01/10 EACH OCCURRENCE $1,000,000 X COMMERCIALGENERALLIABILITY MADE � OCCUR DAMAGE TO RENTED— PREMISES (Ea occurence $ 100,000 MED EXP (Anyone person) $ 5 , 0040 PERSONAL &ADV INJURY $1,000,000 XCLAIMS $5,000 Ded. GENERALAGGREGATE $2,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 17 POLICY PE O X LOC A AUTOMOBILE X LIABILITY ANYAUTO CM012524 05/01/09 05/01/10 COMBINED SINGLE LIMIT (Ea accident) $1"000 , 000 BODILY INJURY (Per person) $ X ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Peraccident) $ X X HIREDAUTOS NON -OWNED AUTOS PROPERTYDAMAGE (Per accident) $ GARAGE LIABILITY- AUTO ONLY -EA ACCIDENT $ OTHERTHAN EAACC $ ANYAUTO $ AUTOONLY: AGG A EXCESSIUMBRELLA LIABILITY CU013619 05/01/09 05/01/10 EACH OCCURRENCE $3,000,000 -X1 OCCUR 1:1CLAIMS MADE AGGREGATE $3,000,000 $ HXDEDUCTIBLE $ RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? WC5098977 07/01/09 07/01/10 X I WCSTATU- OTH- T Y I T ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 OTHER A Liquor Liability CM012524 05/01/09 05/01/10 Per Occ 1,000,000 ggregate 2,000,000 A Employers Liab - Stop Gap ICM012524 05/01/09 05/01/10 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Collindale Golf Course - Restaurant/Snack Bar Concession Agreement Named insured Includes - Collindale 57,L.L.C. d/b/a/ C.B.& Potts The City, its officers, agents and employees are named as Additional insured per policy form 140365 (03/86). C ICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION The City of Fort Collins, Colorado DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 300 LaPorte Avenue IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. rt Collins, CO 80521 AUTHORIZED REPRESENTATIVE USA ACOR (2001/08) tmcki © ACORD CORPORATION 1988