HomeMy WebLinkAboutGREENSHIRE STABLES LLC - INSURANCE CERTIFICATEAmerican Bankers RENEWAL OF FSL-4161751-93
Insurance Company of Florida POLICY DECLARATIONS * * * EFFECTWE
A Stock Insurance Company 12:01 AM STANDARD TIME AT MAILING
ADDRESS OF THE INSURED
8655 E. Via de Ventura
Scottsdale, AZ 85258-3321
POLICY NUMBER
POLICY PERIOD
POLICY TYPE
AGENCY
PAGE 1
FROM TO
FSL4161751
11/15/2012 11/I5/2013
IARMOWNER
OFC9001-0015 .
OF 3
NAMED INSURED AND MAILING ADDRESS
AGENT/ACCOUNT
,GREENSHIRE STABLES,LLC
GOETZ INSURORS INC
SEA-A7vtEDiNS_U E CONTINUATION
227 MAIN ST
4205 S COUNTY ROAD 7
PO BOX 190
FORT COLLINS, CO 80525-9610
FORT MORGAN, CO 80701-2106
0015 CARRUTH, ROBERT J.
The Insured is: ® An -Individual ❑ A Joint Venture
❑ A Partnership ❑ An Organization (Other Than A Partnership or Joint Venture)
❑ A Limited Liability Company
Insured premises:
Item No. Description Location
1 4205 S COUNTY ROAD 7, LARIMER COUNTY, FORT COLLINS, CO 80525
* * * See GL-91 for Additional Farm Premises * * *
This replaces all previously issued Policy Declarations, if any. This Policy applies only to accidents, occurrences, or losses which happen during the
Policy term shown above. This Policy applies only to those coverages below for which a limit of liability or premium charge is shown. "Our" limit
of liability for each coverage shall be not more than the amount stated for such coverage, subject to all the 'terms" of this Policy.
Property Coverages A. Residence B. Related Private C. Personal D. Add'l Living Cost
Structures Property or Fair Rental Value
Limit of Liability $ 527,690 $ 52,768 $ 369,382 $ 105,538
E. Farm Barns, Buildings F. Scheduled Farm G. Unscheduled Farm
and Structures Personal Property Personal Property
Limit of Liability $ 263,487 $ 0 s 50,000
Coverage F: ❑ Pro Rata Distribution Clause
❑ Coinsurance Clause _ Coinsurance Percentage
Coverage G: ® 80 Coinsurance Percentage -- This replaces the percentage under Other Limitations -- Coverage G.
Additional Property Not Covered Under Coverage G:
Deductible: $ 1,000 All Perils Except:
❑ Refer to deductible endorsement.
A2301'1i 1095 A2301(1).meta
meu6er of 1 tG.
American Bankers RENEWAL OF FSL-4161751-93
Insurance Company of Florida POLICY DECLARATIONS * * * EFFECTWE
A Stock Insurance Company 12:01 AM STANDARD TIME AT MAILING
8655 E. via de Ventura ADDRESS OF THE INSURED
Scottsdale, AZ 85258-3321
POLICY NUMBER FROM POLICY PERIOD TO POLICY TYPE AGENCY PAGE 2
FSL 4161751 11/15/2012 I 11/15/2013 IFARMOWNER OFC9001-0015 I OF 3
This Policy is exteneded to cover the following activities, in addition to "farming":
"Farming" is extended to include: Equine related activities as classified elsewhere on the Declarations
and for which a premium is shown.
NAMED INSURED CLAUSE: GREENSHIRE STABLES LLC, HOMER CRAIG
NORRIS, BARBARA LYNN WEST NORRIS
Commercial Liability Each Occurrence Limit Medical Payments to Others -
Coverage $1,000,000 $5,000 per person
General Aggregate Limit Products/Completed Work
(other than Products/ Hazard Aggregate
Completed Work) Limit
$2,000,000 $2,000,000
Fire Legal Liability Limit
$50,000 /per occurrence
Extra Expense Coverage -- Limit of Liability $ POLICY LIMIT
The following "limits" replace those in the Policy for the coverages noted below:
Incidental Property Coverages -- Forms FO-1, FO-2, FO-3, FO-4, or FO-5
Limit of Liability
Fire Department Service Charge
R
POLICY LIMIT
Credit Card, Forgery, and Counterfeit Money
$
POLICY LIMIT
Outdoor Antennas
$
POLICY LIMIT
Well Pumps
$
POLICY LIMIT
Private Power and Light Poles
$
POLICY LIMIT
Refrigerated Food Spoilage
$
POLICY LIMIT
Tenant's Improvements
$
NOT COVERED
Incidental Property Coverages -- Form FO-6
Fire Department Service Charge $ POLICY LIMIT
Property in the Care of a Common or Contract Carrier $ POLICY LIMIT
Signs $ POLICY LIMIT
Glass Breakage in Cabs $ POLICY LIMIT
Farm Operations Records $ POLICY LIMIT
A2301 B(1)-1095 A2301 B(1).meta
member of AMAZInfGroup.
American Bankers
Insurance Company of Florida
A Stock Insurance Company
8655 E. Via de Ventura
Scottsdale, AZ 85258-3321
RENEWAL OF FSL-4161751-93
POLICY DECLARATIONS * * * EFFECTIVE
12:01 AM STANDARD TIME AT MAILING
ADDRESS OF THE INSURED
MORTGAGEE INFORMATION
MORTGAGEEE NAME AND MAILING ADDRESS
1) BANK OF AMERICA, CLIENT 133, PO BOX 1675, CORAOPOLIS, PA 15108-1675
2) FIRST NATIONAL BANK, 205 W OAK ST, FORT COLLINS, CO 80521
LOAN NUMBER
1) 1ST MORTGAGEE, 2) 2ND MORTGAGEE
LIENHOLDER/LOSS PAYEE INFORMATION
SECURED PARTY NAME AND MAILING ADDRESS
LOAN NUMBER
Commercial Liability If this is checked _ coverage does not apply.
All known exposures at the beginning of the Policy period have been identified below.
Classification Code Rating Basis Rate Premium
SUBJECT TO THE FOLLOWING FORMS AND ENDORSEMENTS
AF-9378SM 1095, B830IE0403, B8302E0403, B8318E0205, B8337E0605, B834IE0905, B8344EI109, B837IEl107,
FO-20 1.0, FO-200 1.0, FO-216 1.0, FO-217 1108, FO-3 1.0, FO-309 1.1, FO-341 1.0, FO-360 1.0, FO-362 1.0, FO-368
0699, FO-55 1.0, FO-6 1.0, FO-61 1.2
FO-675 1006, FO-738 0800, GL-10 2.0, GL-40 1.0, GL-610 2.0, GL-612 1.0, GL-73 2.0, GL-81 2.0, GL-810 0305, GL-83
2.0 GL-841 1.0 GL-890 2.0 GL-9 1.0 GL-904 2.0 GL-91 1.0 M7000G-0508
TOTAL POLICY PREMIUM
COUNTERSIGNED:
By: AUTHORIZED AGENT
$4,829
$4,829
DATE
A2301C(1)-1095 A2301C(1).meta
member of ASSLffantGroup
AAIS This endorsement changes the Commercial GL-841
Liability Coverages provided by this policy Ed. 1.0
-- PLEASE READ THIS CAREFULLY --
ADDITIONAL INSURED
DESIGNATED PARTY
Schedule
(The information required below may be shown on a separate schedule or supplemental Declarations.)
Designated Party: CITY OF FORT COLLINS
Designated Activity: ADDITIONAL INSURED/USE OF PASTURE LAND
Designated Interests: GREENSWRE STABLES LLC
The Commercial Liability Coverage is amended as follows:
DEFINITIONS activities designated in the Schedule rating to:
The definition of insured is amended to include the a. your operations;
following: b. premises owned by or rented to you, or
c. other designated interests shown in the Schedule.
Insured also includes the party designated in the
Schedule but only with respect to liability arising out of
GL-841 Ed 1.0
Copyright MCMXCI, American Association of Insurance Services AAIS