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HomeMy WebLinkAbout515849 KEN, LINDA & BRIAN FISHER - INSURANCE CERTIFICATEOP ID: DS CERTIFICATE OF LIABILITY INSURANCE MTEIMMIDD/ �'02112/2013 13 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 endorsements . PRODUCER Phone: 970-8671246 Goetz lnsuror3, Inc. 227 Main St Fax: 970-867-4408 Fort Morgan, CO 80701 Tracy A. Parachini �ICC(� t y� NAMEAO PHONE FAX AIC No Elf AIC No EJMIL ADDRESS: Pao cE OMER ID Y:FISH-KE CUS INSURE 5 AFFORDING COVERgGE INSURERA:American Bankers Insurance Co NAIC0 10111 INSURED Ken, Linda & Brian Fisher Kenlyn Stables, Inc INSURER B: 4916 Bingham Hill Rd INSURER C: Fort Collins, CO 80521-1073 INSURER D : INSURER E : INSURER F : "- "-"'�-'•' RCVIJIVN NUMHGK: 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. E OF INSURANCE POLICY NUMBER MMILDDDlYYVY M LMIDDYEYYY LIMITS TY ALGENERALLIABILITY S-MADE � OCCUR M X FSL4160697 11/20/2012 1112012013 EACH OCCURRENCE $ 1,000,00 pREMISEs Eaamr713 rrence MED EXP (Airy we Person) $ 50,00 $ 5,00 PERSONAL A ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 TE LIMIT APPLIES PER: PRO- LCC PRODUCTS-COMP/OPAGG $ 2,000,00 $ AUTOMOBILE LIAMUTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNEDAUTOS COMBINED SINGLE LIMIT (Ea accitlenf) $ BODILY INJURY (Par person) $ BODILY INJURY (Per ecddenU q PROPERTY DAMAGE (Per ecdtlenf) $ f f UMBRELLA LAB EXCESS LAB OCCUR C1_AIMSA1AOE N/A EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION WORKERS COMPENSATION AND EMPLOYERS VERS'LILIABIUTY YIN ANY PROPR ETC)RrPARTNERIEXECUTIVE OFFICERNEMBER EXCLUDED? ❑ If ..Ai I,e NH) Ifyes,desvlhe H) DE SCRIPTIONOFOPERATIONSb J. $ WC STATU- OTH. E E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Aflach ACORD 101, AWAIMal Remarks Schedule, It mole apace is requlfed) - - - Certificate holder is additional insured in respect to hay operation. T Additional insured includes The City, its officers, agents and employees. Kenneth P.F18hei 4916 Bingham Hill Rd. ' Fort Collins, CO 80521-1073 rGRT¢Ir ATc unI non FTCOLLI The City of Fort Collins Purchasing Department PO Box 580 Fort 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. AUTHORUMD REPRESENTATIVE Tracy A. Parachini ACORD CORPORATION. All rights •- I---- -.f 1lie ml-umu name and logo are registered marks of ACORD