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Home My WebLink AboutLEWIS TENNIS LLC - INSURANCE CERTIFICATE (2)Fm:Ewing-Leavitt Insurance To:City of Fort Collins (19702216782) 13:11 08/03/10GMT-06 Pg 02-03 ACOR4N CERTIFICATE OF LIABILITY INSURANCE Ewing -Leavitt Insurance Agency 4025 St. Cloud Dr. Suite 100 Loveland, CO 80538 INSURED Lewis Tennis LLC 1205 W Elizabeth ST. #PMB111 Fort Collins, CO 80521 PP11 INSURERS AFFORDING COVERAGE INSURERA- Auto Owners INSURER B. INSURER C. INSURER U. INSURER E' NAIC # 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 MAYBE 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 LTR D' N50. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYYYV POLICYEXPIRATION DATE MMIDDIYYYV LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR Hired & Non -Owned 74687368 07/IS/2010 07/15/2011 EACHOCCURRENCE $ 1000 ,000 _ PREMISES (Ea occurrence) _ $ 50,00 $ 5,00 MED EXP(Any00a Parscn) X PERSONAL S ADV INJURY $ 1,000, AMYo:$1,000,000 GENERAL AGGREGATE $ 2,000,00 CENT AGGREGATE LIMI I APPLIES TER X OLICY PRO- PLOC JECT PHUUUGI5-CUMPIUP AUG $ 2,000,00 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ ALL OWNED AUTOS SCHEDULEDAUTOS NJ BODI ODI YINJ LY INJURY LY $ HIRED AUTOS NON -OWNED AUTOS BODILY INJURY (Par ocPd.np $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY..............EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: qGG $ EXCESS I UMBRELLA LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ AGGREGATE g DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PERMEMBER/PARTNERIE%ECUTNE� EXCLUDED? OPFICER,y A U TORY LIMITS ER $ EL EACH ACCIDENT $ Ia NHR dyes.di In and Il yes. d L PRO ISU SPECIAL PROVISIONS below OTNER EL DISEASEEAEMPLOYEE $ EL.DISEASE - POLICY LIMB $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ertificate holder is an Additional Insured. CFRTIFICATF Nnl nFR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI DATE TH EREOE 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 City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF MY KIND UPON THE INSURER, ITS AGENTS OR PO Box 580 REPRESENTATIVES. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE !n 970. rim.,. wnu ,wmB Biro logo are Tegrscerea marks OT ACORD PDF created with FinePrint pdfFactory trial version www.Ddffactory.com Fm:Ewing-Leavitt Insurance To:City of Fort Collins (19702216782) 13:11 08103110G MT-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 This Certificate of Insurance 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. PDF created with FinePrint pdfFactory trial version www.adffactorv.com Fm:Ewing-Leavitt Insurance To:City of Fort Collins (19702216782) 13:11 08103/1 OGMT-06 Pg 01-03 Please see the following page; Certificate of insurance for Lewis Tennis LLC. Toni Garcia, CISR Select Accounts Manager 4025 St. Cloud Dr. Suite 100 Loveland CO 80538 Direct Line: 970-679-7360 Direct Fax: 1-866-232-0309 Email: ton i-earcia6i�ieavittxom E-MAIL/FAX CONFIDENTIALITY NOTICE: The contents of this e-mail/fax message and any attachments are intended solely for the addressee(s) and may contain confidential and/or legally privileged information. If you are not the intended recipient of this message or if this message has been addressed to you in error, please immediately alert the sender by reply e-mail and then delete this message and any attachments. If you we not the intended recipient, you are notified that any use, dissemination, distribution, copying, or storage of this message or any attachment is strictly prohibited.