HomeMy WebLinkAboutGRANT FAMILY FARMS INC - INSURANCE CERTIFICATE,acoRo® CERTIFICATE OF LIABILITY INSURANCE .
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F GATE(0/7m MIDD/Y1
1D/7/2011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.'
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate doesnotconfer rights to the
certificate holder in lieu of such endorsements .
PRODUCER
Moody Insurance Agency, Inc..
BOSS East Tufts Avenue
Suite 1000.
Denver CO 80237
CONTACT Julie Bell -- - NAME,
PHONE (3O3)824-6600 _. _- F N (303)370-0118
E-MAIL .1. jbell@moodyins. Com
INSUI AFFORDING COVERAGE
NAIC#
INSURER A:Travelers Indenmity Company
25658
INSURED
Grant Family Farms, Inc.
1020 WCR 72
Wellington CO 80549
INSURERB:Rislt Placement Services, Inc
I INSURER C:
INSURERD:
NSURER E:
1 INSURER F:
COVERAGES CERTIFICATE NUMBER: RFVICION NIIMRFR-
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
TYPE OF INSURANCEluawill
ADDLSUBR
POLICY NUMBER
POLICY EFF
MM/DDNYY
POLICY EXP
MWDDNYYV
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE ril OCCUR
7007A183375IND11
0/1/2011
0/1/2012
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 100,000
MED EXP Arry one person)
$ 51000
PERSONAL B ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS - COMP/OP AGO
$ 2,000,000
RO LOG
X POLICY PIPCT
.$
CEOM�BINEDtSINGLE LIMIT-
1 000 000
BODILY INJURY (Per person)
$_entALL
B
ANY AUTO -
OWNED SCHEDULED
AUTOS AUTOS(
AP0731633
0/1/2011
0/1/2012
POMOSILELIABILMY
BODILY INJURY Per accid
)NON
$
-OWNED
AUTOS X AUTOS
PROPERTY DAMAGEHIRED
Per ident : '
$
Uninsured motorist combined
$ 1 000,000
X
UMBRELLA LIAB
OCCUR
-
EACH OCCURRENCE
$ 51000,000
AGGREGATE
$ 51000,000
A
EXCESS LIAB
CLAIMS -MADE
CEO X RETENTION 250
$
Ex7A18337SIND11
10/1/2011
0/1/2012
WORKERS COMPENSATION
WC STATU- DTH-
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? El
NIA
M
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYE
$
(Mandatory in NH)
If yes, describe under
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, B more space is required)
1986 BMW vin #5696 inlcuded in auto policy above.
(970)416-2162
City of Fort Collins
215 N. Mason St.
PO Box 580
Fort Collins, CO 80522
uvlrl
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
is Bell/ANGMAR �'�-"�`� •R�
01988-2010 ACORD CORPORATION. All rights rasarvad
INS025 (201005).01 The ACORD name and logo are registered marks of ACORD