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Home My WebLink About490634 DOUGLAS B HOLT & TUBA USTUNER - INSURANCE CERTIFICATE (3)HOLTD-1 OP ID: KS ,Ac�oRo CERTIFICATE OF LIABILITY INSURANCE DAT03128/rrrrr) 03/28/14 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 Phone: 970-945-9161 NAMEµ GIA Groupp/Glenwood Ins. Agency PHOxE. _ - _— ------ FAx __-- -"- P O Box 1270 Fax: 970-945-6027 N Ell, I INC,No: Glenwood Springs, CO 81602-1270 ADDREAIL SS: Robert Asa Jones INSURER B AFFORDING COVERAGE NAIL S INSURER A: Cincinnati Insurance Company INSURED Douglas B. Holt & Tuba Ustune INSURERS: 223 Jefferson St. 063� INSURERC: Fort Collins, CO 80524 INSURER D 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 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 POLICY NUMBER WDCDY EFF POLICY FxP M umrra GENERAL LIABILITY EACH OCCURRENCE t 1,000,00 PREMISES(Ea nenca $ 500,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F—xl OCCUR ENP0190320 04/03/14 04/03/15 MED EXP (Any one person) 1 5,00 PERSONAL A ADV INJURY _ $ 1,000,00 GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES -PER: PRODUCTS-COMP/OP AGO $ 2,000,00 b POLICY PRO- LOC - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Me accident) BODILY INJURY (Per person) $ ANY AUTO BODILY INJURY (Per accident) $ ALLOWNED SCHEDULED AUTOS AUTOS (Per accident DAMAGE $ HIRED AUTOS NON -OWNED $ UMBRELLA LIAR OCCUR - EACH OCCURRENCE $ 1,000,0 AGGREGATE $ A EXCESS LIAR CLAIMS4AADE ENP0190320 04/=14 04=15 DIED I X I RETENTION $ WORKERS COMPENSATION WCSTATU- OTH• ITO IS ITS R AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNI RWrXECUTIVE E.L. EACH. ACCIDENT S OFFICERIMEMBER EXCLUDED? ❑ (Mandatory In NH) N IA E.L. DISEASE - EA EMPLOYEE 3 E.L. DISEASE -POLICY LIMIT S If yes, describe under DESCRIPTION OF OPERATIONSbal. A Property Section X ENP0190320 04/03/14 04/03/15 OESCRIPTKNI OF OPERATIONS I LOCATIONS I VEHICLES (Atbch ACORD 101. Additional Bemerha Schedule, It men space Is required) Certificate holder is named as additional insured. RE: 221-227 Jefferson St. Fort Collins, CO City of Fort Collins P.O. Box 280 Fort Collins, CO 80522 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 ;qaL U 1966-ZU1U AGUKU GUKYUKAI IUN. All rignTS reserveo. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD