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Home My WebLink AboutAMERICAN BICYCLE ASSOCIATION - INSURANCE CERTIFICATEClient#: 1067930 AMERIBICI ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY) 2/z1/2014 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(les) 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 USI Insurance Services LLC-CL 2201 E. Camelback Rd Suite 220A I to Ea:602-279-SBW Niel: 602- 79-S899 E-MAIL hx-certi icates@usl.bfx ADORE ss: P Phoenix, AZ 85016 INSURER(S) AFPORDINGO:0 GE NAIC0 INSURER A: Philadelphia Indemnity Insurano 118058 INSURED American Bicycle Association DBA: USA BMX INSURER e : INSURER C: P.O. Box 718 INSURER 0 Chandler, AZ 85244 INSURERS : . INSURER F: COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 pR TYPE OF INSURANCE ADDL N UBR WV POLICY NUMBER POIbIDFF M ECCLAIMS. MMIDD/YYY LIMITS A GENERAL LIABILITY X' COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ^I OCCUR Y Y PHPK1136495 3/0112014 03/0112011 E100000o DEAACCH�GOECCURpRENCE PREMISE FjoccTu anco E100000 MED EXP (Any ono raon) EEXcklded PERSONAL SADV INJURY $1000000 ES 00O ODD GENERAL AGGREGATE GEN'L AGGREGATE X POLICY LIMIT APPLIES PER: 7 PRO El LOC PRODUCTS - COMP/OP AGG _ $1000000 Abuse/Molest Et 000 000 A AUTOMOBILELIABB.RY X, ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X HIRED AUTOS X NON -OWNED AUTOS PHPK1136495 1/2D14 0'"1/201 COMBINED eOMBII D SINGLE UNIT 1 DOO,DDO BODILY INJURY Pan person) S BODILY INJURY (Per eeddem) $ E PROPERTY DAMAGE arekin - $ A X UMBRELLA UAS EXCESS LWB OCCUR CLAIMS -MADE Y Y PHU13450342 01/2014 03/01/2016 EACHOOCURRENCE E4000000 E4 D00 DDD N AGGREGATE DED X RETENTION E1O 000 _ S WORKERS COMPENSATION AND EMPLOYERTUASILITY YIN PROPRIETORIPARTNERIEXECUTIVE OFFICER/MEMSER EXCLUDED? (Mandatory In NH) 11 Y describe under DESCRIPTION OF OPERATIONSI»low N/A WCSTATU- OTH- To YANY _ E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE -- S E.L. DISEASE -POLICY LIMIT E _ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ARaeh ACORD 101, Additional Remarks Schedule, If more spaces Is required) The General Liability policy includes a blanket automatic Additional Insured endorsement that provides Additional Insured and a Blanket Waiver of Subrogation status to the Certificate holder, only when there is a written contract or written agreement between the named insured and the certificate holder that requires such status, and only with regard to the above referenced on behalf of the named insured. The General Liability policy contains a special endorsement with 'Primary and Noncontributory" wording. Re: Epic BMX City of Ft. Collins P.O. Box 580 Ft. 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 1 of 1 #S11713667/M11713223 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CXTJD Client#:1067930 AMERIBICI ACORD CERTIFICATE OF LIABILITY INSURANCE TE D2/21/2.DD/YYYV) /zvzola 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(les) 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 USI Insurance Services LLC-CL 2201 E. Camelback Rd Suite 220A NAME: pa"g"ri Ea:602.279-5800 A/c No: 602-279.5899 noDRLFss: phx-Certificates@usi.bix Phoenix, AZ 85016 INSURERS AFFORDING COVERAGE NAICIf INSURER A: Philadelphia Indemnity Inswanc 18058 INSURED American Bicycle Association DBA: USA BMX INSURERS: INSURER C P.O. BOX 718 INSURER D: Chandler, AZ 85244 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER: 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 CONTRACTOR 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 �Tp TYPE OF INSURANCE IND L UB pOUCY NUMBER MMIDDNYI�'1' y EECLAIMS. MWDCD/YYYP LIMITS A GENERAL LIABILITY XI COMMERCIAL GENERAL LIABILITY CLAIM"ADE �X OCCUR Y Y PHPK1136495 PHPK1136495 3/0112014 3/01/2014 03101/2016 EEpAApNCk��1HHp $1000000 �OEECCC?URRENCE PREMISES D $100000 MEDEXP Anyone pawarl sExcluded PERSONAL a ADV INJURY $1000,000 GENERAL AGGREGATE s5,000,000 GENL AGGREGATE X POUCY LIMIT APPLIES PER: �P - �_ LOC PRODUCTS - COMP/OP AGO $1 000000 Abuse/Molest COMBINED SINGLE LIMIT fEs accident) $11,000,000 1,000,000 A AumMOBILEunBILm I X1 ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X. HIRED AUTOS X �-0WHED AUTOS 03/01/201 BODILY INJURY (Per pawn) $ BODILY INJURY (Per accident)ni) E PROPERTVDAMAGE E E A )( UMBRELLA LIAR EXCESS LIAR_ X I OCCUR CLAIMS -MADE Y Y PHUB450342 1 3/01/2014 03/01/2015 EACH OCCURRENCE E4 000 ODO AGGREGATE s4,000,000 DED XRETENTION $10,000 1$ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUIVE V/" OFFICEIRMEMBER EXCLUDED? (Mendetcry in NH) h yea, describe under DESCRIPTION OF OPERATIONS below N/A WC STATU- OTH- E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT E DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Amch ACORD 101, Additional Remarks Schedule, If more space is required) The General Liability policy includes a blanket automatic Additional Insured endorsement that provides Additional Insured and a Blanket Waiver of Subrogation status to the Certificate holder, only when there is a written contract or written agreement between the named insured and the certificate holder that requires such status, and only with regard to the above referenced on behalf of the named insured. The General Liability policy contains a special endorsement with "Primary and Noncontributory" wording. RE: Epic BMX #1352 City of Fort Collins C/O John Stephen 215 N. Mason Fort Collins, CO 80524-0000 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 ACORD 25 (2010/05) 1 Oft #S11713664/M11713223 01988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CXTJD