HomeMy WebLinkAboutROLEXIS INC DBA TEAM SPORT PHOTO - INSURANCE CERTIFICATESENTRY INSURANCE A MUTUAL. COMPANY SENTRY'S BUSINESSOWNERS
STEVENS POINT, WISCONSIN POLICY
(A PARTICIPATING MUTUAL COMPANY)
A MEMBER OF THE SENTRY FAMILY OF INSURANCE COMPANIES
POLICY NUMBER 49-99863-01
NAME INSURED: ROLEXIS INC DBA
TEAM SPORT PHOTO
ADDITIONAL INSURED
SCHEDULE
The following information is required to complete the accompanying
additional insured endorsement which forms a part of the Named Insured's
BUSINESSOWNERS POLICY.
ADDITIONAL
INSURED ENDORSEMENT
CITY OF FORT COLLINS BP 14 65 06 10
PO BOX 5B0
215 N MASON ST 2ND FL
FORT COLLINS, CO 80522
(CERTIFICATE NUMBER 0010)
LOCATION(S) OF COVERED OPERATIONS
CITY OF FORT COLLINS
PO BOX 580
215 N MASON ST 2ND FL
FORT COLLINS, CO 80522
JOB: GOING ONSITE TO TAKE PHOTOS
FOR ENDORSEMENT TEXT,
SEE OVER.
BP 89 05 01 87 (MECH)
TEA 49-99863-01 00 131
10-22-2013
(000 0010)
EFFECTIVE
FROM OCTOBER 22, 2013
TO JANUARY 01, 2014
02641
SENTRY INSURANCE A MUTUAL COMPANY
STEVENS POINT, WISCONSIN
(A PARTICIPATING MUTUAL COMPANY)
A MEMBER OF THE SENTRY FAMILY OF INSURANCE COMPANIES
CERTIFICATE OF INSURANCE
ACCOUNT NUMBER 49-99863
This certificate is issued as a matter of information only and confers no
rights upon the certificate holder. This certificate does not amend,
extend or alter the coverage afforded by the policies below.
Name and Address of
Certificate Holder
CITY OF FORT COLLINS
PO BOX 580
215 N MASON ST 2ND FL
FORT COLLINS, CO 80522
Name and Address
of the Insured
ROLEXIS INC DBA
TEAM SPORT PHOTO
11880 UPHAM ST UNIT A
BROOMFIELD, CO 80020
This certificate is issued on 10-22-2013 and is effective until
01-01-2014. It certifies that policies of insurance listed below have
been issued to the insured named above. Notwithstanding any requirement,
term or conditiun 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.
Coverage Provided Policy Number
Coverage
Limits
Businessowners Liability 49-99863-01
Each Occurrence
S
1,000,000
Medical
Expense
S
10,000
Includes: Bodily Injury
Damage to
Premises
$
100,000
Property Damage
General
Aggregate
$
31000,000
Personal Injury
Products
Aggregate
S
3,000,000
Hired and Non -Owned Auto
Should any of the above described policies be cancelled before the
expiration date thereof, notice will be delivered in accordance
with the policy provisions.
80-C1035 (MECH)
TEA 49-99863
10-22-2013
PAGE 1
(0010)
31-060501
LDI COI 269628-1 02 11
02636