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HomeMy WebLinkAboutLEWIS TENNIS LLC - INSURANCE CERTIFICATE (7)ACORpo CERTIFICATE OF LIABILITY INSURANCE oe%1%zoia 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 endomemerd(s),I - - PRODUCER - `Ewiri 1ea4.iit.:Insurance.A enc _._.__'__ 9- I e,. 9 _ -y J .__.__._.. 4025 St. Cloud_ Dr. Suite 100 ... _ Loveland, CO 80538 -- NAME: .- °HONE 970.679.7333 - 866:456.4265- AIC NO Est: ;.�' AIC. No: ADDRESS: -'- INSURER(S) AFFORDING COVERAGE NAICA . INSURER A: Auto Owners 18988 inu!%pLewis Tennis .LLC 1205 W Elizabeth ST. #PMB111 Fort Collins, CO 80521 INSURER B: INSURER C: INSURER D: INSURER E INSURER F COVERAGES ' CERTIFICATE NUMBER:. 13-14 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 AN`! 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. ' LTR TYPE OF INSURANCE INSR VIVO POLICY NUMBER POLICY CYEFF MMIDDIWYY LIMITS A GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE rX I OCCUR X 74687368-1 07115/2013 - 07/1512014 EACH OCCURRENCE S 1,000,00 PREMISES (Ea oavrmnce) $ 50,00 MEDEXP(Any one permn) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: JECT17 POLICY P" LOC PRODUCTS COMPMP AGG $ 2,060,00 $ ' AUTOMOBILE LIABILITY: .� _,. •�'. ANY AUTO-- .-_ _ __ _ _... ALL OS ° AUTOS SCHEDULED' AIfrO NON -OWNED HIRED AUTOS AUTOS .. .. - .. ' .••. - '- - - -' aacWent) $ .-_ BODILY INJURYP (Per Person) .._ .. $ " BODILY INJURY (Per actlden) S -- — eraceidere $ UMBRELLA UAB EXCESS W18 OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DIED I I RETENTION S $ WORKERS COMPENSATION ANDEMPLOYERS'LIABILITY YIN ANY PROPRIETORPARTNER/D(ECUTIVEO OFFICERIMEMBER EXCLUDED? (Mandatory in NH) It yes, desent,o under DESCRIPTION OF OPERATIONS below NIA - TORYLIMITS ER E.L. EACH ACCIDENT $ E. L. DISEASEEAEMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) City of Fort Collins is named as an Additional Insured. FAX: 970.221.6782 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins PO Box 580 Fort Collins, CO 80522 ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD