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Home My WebLink AboutSURROUNDINGS LLC - INSURANCE CERTIFICATEOP ID: RC 'fili """ CERTIFICATE OF LIABILITY INSURANCE DATUM/201""' 03113/2013 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 does not confer rights to the certificate holder in lieu of such endorsement(s). _ PRODUCER Phone: 970-635-9400 PFS Insurance Group - JT 4848 Thompson Pkwy, Ste 200 Fax: 970-635-9401 Johnstown, CO 80534 Dave Janssen CONTACT - PHONE FAX AID, No Ex) : A/C. No): - E-MAIL ADDRESS: PRODUCER SURRO-2 CUSTOMER ID p: INSURER S) AFFORDING COVERAGE NAIC N INSURED Surroundings, LLC Andy Mill 6121 E. Harmony Road INSURER A:ACUity Insurance Co. 14184 INSURER B: Fort Collins, CO 80525 INSURER C: INSURER D INSURER E INSURER F COVERAGES CERTIFICATF NIIMRFR• DCtnernu uI raa DCD. 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 INSURANCE ADDL IINRIR UBR wun POLICY NUMBER POLICYEFF MMIDDIYYYY POLICYEXP MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X39278 04/01/2013 04/01/2014 AMA ETOR N PREMISES JEa occurrence E — 300,000 CLAIMS -MADE Fvl OCCUR . VIED EXP (Any one person) $ -- 5,000 PERSONAL B ADV INJURY $-- -1,000,000 .,.-.. ..-_._.... _ _.. ._. '. GENERAL AGGREGATE - 3 ..-2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS: COMPIOP AGG $ 2,000,000 ' POLICY PRO- n IPrJLOC - _ $ AUTOMOBILE LIABILITY - _ COMBINED SINGLE LIMIT A ANY AUTO X39278 04/01/2013 04101/2014 (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ _ ALL OWNED AUTOS ' BODILY INJURY (Per accident $ SCHEDULED AUTOS X PROPERTY DAMAGE $ HIRED AUTOS (Per accident X $ NON -OWNED AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE X39278 04/01/2013 04/01/2014 DEDUCTIBLE 8 X I RETENTION $ 0 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY YIN RY R . E.LEACH ACCIDENT $ ANY PROPMETORIPARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ NIA E.L. DISEASE EA EMPLOYEE $ (Mandatory In NH) If yes, describe under E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS below A Property Section 04101/2013 04/0112014 Limits See Belo A (X39278 Deductibl 500 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attagh ACORD 101, Additional Remarks Schedule, If more space is required) If required by written agreement, the certificate holder is included as additional insured for ongoing operations under general liability. Business Personal Property $300,000 Limit. FORTCOL City of Fort Collins PO Box 580 Fort Collins, CO 80522 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 b/2� ram.--- U 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD