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HomeMy WebLinkAboutNORTHERN HOTEL FORT COLLINS LP DBA NORTHERN HOTEL - INSURANCE CERTIFICATEi T ® A� CERTIFICATE OF LIABILITY INSURANCE DIY ATE(MM/DDYYY) 06/05/2013 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 1-425-454-3386 Arthur J. Gallagher Risk Management Services, Inc. CONTACT Joanne Manion NAME: PHONE FAX INC. No. Eul.425-454-3386 aC No: 425-451-3716 E-MAIL ADDRESS: P.O. Box 367 INSURERS AFFORDING COVERAGE NAIC9 Bellevue, WA 98009-0367 INSURER A: LEXINGTON INS CO 19437 INSURED INSURER B : Northern Hotel Fort Collins, LP "— DBA: Northern Hotel INSURER C: INSURER D: National Development Council INSURER E: 332 Michigan Avenue Pueblo, CO 81004 INSURER F: COVERAGES CERTIFICATE NUMBER: 34040614 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 HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE A DDL SUER POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY EXP MM/DDIYYYY LIMBS A GENERAL LIABILITY 13135940 05/30/1 05/30/14 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea o¢urrence $ 50, 000 CLAIMS -MADE O OCCUR MED EXP (Any one person) $ Excluded PERSONAL S ADV INJURY $11000,000 GENERAL AGGREGATE $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2, 000,000 POLICY PRO- ECT X LOO $ A AUTOMOBILE LIABILITY 13135940 OS 30 1 05/30/14 COMBINED SINGLE LIMIT Ea acr dent 1,000,000 BODILY INJURY (Per person) $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par ..dent) $ X PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS X AUTOS A X UMBRELLA LIAB X OCCUR 13136436 05/30/1 05/30/14 EACH OCCURRENCE $ 25,000,000 _ AGGREGATE $25,000,000 EXCESS LIAB CLAIMS -MADE DED X RETENTION$ 10, 000 I $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE❑ E. L. EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? NIA E.L. DISEASE - EA EMPLOYE $ (Mandatory in NH) If yes, descnhe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, it more space Is m9uired) Northern Hotel 172 N. College Avenue Fort Collins, CO 80525 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. P. O. Box 5.80 AUTHORIZED REPRESENTATIVE ' Fort Collins, CO 80522-../........./1:., - I USA ACORD 25 (2010105) jomanion 34040614 U 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACORDr, EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DATE 06/05/2013 THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY. PRODUCER NAME. CONTACT PHONE 1-425-454-3386 COMPANY NAME AND ADDRESS NAIL NO: PERSON AND ADDRESS FAX INC NHo: 1-425-451-3716 Underwriters at Lloyd's London ADDRESS: Allied World Assurance Company Arthur S. Gallagher Risk Management Services, Inc. First Specialty Insurance Corp. P.O. Box 367 Liberty Surplus Insurance Corp. Continental Casualty (Equipment Breakdown) Bellevue WA 8009-0367 MULTIPLE COMPANIES, COMPLETE SEPARATE FORM FOR EACH CODESUB CODE: AGENCY CUSTOMERIF NAMED INSURED AND ADDRESS LOANNUMBER POLICY NUMBER Northern Hotel Fort Collins, LP DBA: Northern Hotel N13NA04170 National Development Council EFFECTIVE DATE EXPIRATION DATE 332 Michigan Avenue CONTINUED UNTIL Pueblo, CO 81004 05/30/13 05/30/14 TERMINATED IF CHECKED ADDITIONAL NAMED INSURED(S) THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION (Use additional sheets if more space is required) LOCATIONMESCRIPNON Northern Hotel 172 N. College Avenue Fort Collins, CO 80525 rAVFGAr]G IMPnIPMATIIIM X COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 10,583,200 DED: 1,000 YES NO BUSINESS INCOME / RENTAL VALUE x If YES, LIMIT: 553, 150 X Actual Loss Sustained # of months: 12 BLANKET COVERAGE x If YES. indicate amount of insurance on properties identified above: $50, 000, 000 TERRORISM COVERAGE x Attach signed Disclosure Notice/DEC IS COVERAGE PROVIDED FOR'CERTIFIED ACTS' ONLY? If YES, SUB LIMIT: DED: IS COVERAGE A STAND ALONE POLICY? If YES, LIMIT: DED: DOES COVERAGE INCLUDE DOMESTIC TERRORISM? If YES, SUBLIMIT: DED: COVERAGE FOR MOLD If YES, LIMIT: DED: MOLD EXCLUSION (If "YES', specify organization's form used) REPLACEMENTCOST x AGREED AMOUNT x COINSURANCE If YES, % EQUIPMENT BREAKDOWN (if Applicable) x If YES, LIMIT: 50,000,000 DED: 10,000 LAWANDORDINANCE-Coverage for loss to undamaged portion of building x If YES, LIMIT: 50,000,000 DED: 1,000 - Demolition Costs x If YES, LIMIT: 1,000,000 DED: 1,000 - Incr. Cost of Construction x If YES, LIMIT: 1,000,000 DED: 1,000 EARTHQUAKE (if Applicable) x If YES, LIMIT: 5, 000,000 DED: 100,000 FLOOD (if Applicable) x If YES, LIMIT: 5, 000, 000 DED: 100,000 WIND / HAIL (If Separate Policy) x If YES, LIMIT: DED: PERMISSION TO WAIVE SUBROGATION PRIOR TO LOSS KEMAKKS - Including Special Conditions (Use additional sheets if more space is required) Northern Hotel 172 N. College Avenue Fort Collins, CO 80525 CANCELLATION THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE POLICY BE TERMINATED, THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW 30 DAYS WRITTEN NOTICE, AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW. AUUI I IUNAL IN I ERES I NAME AND ADDRESS LENDER SERVICING AGENT NAME AND ADDRESS City of Fort Collins P. O. Box 580 Fort Collins, CO 80522 USA MORTGAGEE LOSS PAYEE ADDITIONAL INSURED AUTHORIZED REPRESENTATIVE / w �/ /�✓/TI /6- - ACORD 26 (2003110) jomanion © ACORD CORPORATION 2003 34040624