No preview available
HomeMy WebLinkAboutLEWIS TENNIS LLC - INSURANCE CERTIFICATE (3)ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) TM 06/15/2010 PRODUCER (970)679-7333 FAX (866)456-4265 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Ewing -Leavitt Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 4025 St. Cloud Dr. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 100 Loveland, CO 80538 INSURERS AFFORDING COVERAGE NAIC # INSURED Lewis Tennis LLC INSURERA: Auto Owners -- 18988 - - 1205 W Elizabeth ST.-#PMB111 INSURERB: Fort Collins,. CO _80521' NSURERC: INSURER D: 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. INSR LTR ADDT NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YYYY POLICY EXPIRATION DATE MM/DD/YYYY LIMITS GENERAL LIABILITY 74687368 07/15/2010 07/15/2011 EACH OCCURRENCE $ 1, 000 , 000 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR DAMAGE TOR NTED PREMISES Ea occurrence $ 50,000 MED EXP (Any one person) $ S,000 A X Hired 8r Non -Owned PERSONAL & ADV INJURY $ 1,000,000 Auto : $1 , 000 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO - JECT AUTOMOBILE AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS '�•` HIREDAUTOS, NON -OWNED AUTOS -- �' BODILY INJURY -(Per accident) - - ' $ - PROPERTY DAMAGE (Per accident) -- - -- $ -- - _ - GARAGE LIABILITY - - AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC - $ ANY AUTO $ AUTO ONLY: AGG EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ WORKERS COMPENSATION WI A - - AND EMPLOYERS' LIABILITY Y / N ANY PROPRIFTOR/PARTNERIFXFCUTIVE� OFFICER/MEMBER EXCLUDED? I TCRY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ertificate holder is an Additional Insured. l.tK I Wlt AI t t1VLUtK CANCELLATION 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 DO SO SHALL City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR PO Box 580 REPRESENTATIVES. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE [Toni Garcia/TOGARC ACORD 25 (2009101) FAX: 970. 221.6707 ©1988-2009 ACORD CORPORATION- All rinhtc rPSPrvPrl The ACORD name and logo are registered marks of ACORD 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. ACORD 25 (2009/01)