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Home My WebLink AboutAMERICAN BICYCLE ASSOCIATION (EPIC BMX) - INSURANCE CERTIFICATEACORlJ® CERTIFICATE OF LIABILITY INSURANCE OA EtMM DO YYY) 2/27/2012 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(les) 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 does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAME:CT -. - - - �_ � ICk PIICher Insurance, Inc. 2201 East CamelbaCk Road Suite 220A PHOPE AID Ne EA):60-279-5800 AIc Ne :602-279-5899 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIL* Phoenix AZ85016 INSURER A:Philadel hia Indemnity Ins. Cc INSURED AMERI-4 INSURER B: INSURER C: American Bicycle Association P.O. Box 718 Chandler AZ 85244 INSURER D: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 1094587647 REVISION NUMBER: 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 HAV E BEEN REDUCED BY PAID CLAIMS. INSR LTR rypE OF INSURANCE INSR WVD POLICY NUMBER POLICY EFF MMMDNYYI' POLICY EXP JMMMDNYYYI LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE IT]OCCUR HPK83D294 /12012 12013 EACH OCCURRENCE $1,000,000 PREMISESEa ocmnence $100,000 MED EXP(My one person) $Excluded - PERSONALBADV INJURY -$1,000,000 GENERA- AGGREGATE $6,000.000 GENT AGGREGATE POLICY LIMIT APPLIES PER: "0 TOO XCT PRODUCTS - COMP/OP AGG $1,000000 - Abuse/Molestation $1.000,000 AUTOMOBILE X UTABIU`P( •. MY AUTO ALL OWNED SCHEWLED AUTOS AUTOS HIRED AUTOS X NON-OMED AUTOS AUTOS PHPK83D290 _ 12012 12013 Ea epp�der$ 100o aoo. BODILY INJJRY(Per person) S BODILY INJJRY (Perecddeni $ PROPERTY DAMAGE Perecddert . E UMBRELLA LIAR EXCESS LIAB X OCCUR CLAIMSMADE PHUB374030 /12012 12013 EACH OCCURRENCE $4,000,000 AGGREGATE $4,000,000 DED I X RETENTION$ 10,000 $ WORKERSCOMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETONPARTNERr ECUTIVE OFFICERMIEMBER EXCLUDEM ❑ (MandaporY h NH) It cgs, desmbe under DESCRIPTION OF OPERATIONS WI. NIA I WC STATU- OTH- TORYUMF R E.L. EACHACCIDENT $ EL. DISEASE - EA EMPLOYEE $ EL DISEASE-POLICYLMIT $ DESCM"ON OF OPERATIONS I LOCATIONS I VEHICLES (Adech ACORD 1D1, AddlaonM Ramalkr Schedule, If more apace la required) Certificate holder is named as additional insured as their interest may appear per form PI-AM-002 Re: Epic BMX City of Ft. Collins P.O. Box 580 Ft. Collins CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Oa 1988-2010 ACORD ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD PI-AM-002 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - CERTIFICATE HOLDERS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SECTION II —WHO IS AN INSURED is amended to include any Certificate Holder, identified as an additional insured, on a Certificate of Insurance issued by Philadelphia Indemnity Insurance Company or our authorized representative, but only for liability arising out of the negligence of the named insured. The limits of insurance applicable to these additional insureds are the lesser of the policy limits or those limits specified in a contract or agreement. These limits are inclusive of and not in addition to the limits of insurance shown in the declarations. Page 1 of 1