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HomeMy WebLinkAbout260459 PLAY POINTE LLC DBA FORT FUN - INSURANCE CERTIFICATEA� Oe CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNY 5/29/2014YY) 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 endomement(s). PRODUCER CENTENNIAL INSURANCE AGENCY, LLC. 1515 Fortino Blvd. 2nd Floor Pueblo CO 8100E CONTACT Carlie GenOVa NAME: PHONE (719) 544-1111 FAICAX No: (719)545-5120 AbmpAgLESS. cgenova@centennial-ins.com INSURERS AFFORDING COVERAGE NAIC It INSURERA:THE Insurance Company INSUREDRou)-tINSURER Play Pointe, LLC DBA: Fort Fun 1513 E. Mulberry Fort Collins CO 80524 B:Plnnacol Assurance 41190 INSURERC: INSURER D: INSURER E: 1 INSURER F: COVERAGES CERTIFICATE NUMBER:14-15 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 ADDL 5UmK POLICY NUMBER POLICY EFF IMMIDDIYYYYJ POLICY EXP (MMIDDIYYYTILIMITS A GENERALLIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR X PP0101471-04 /30/2014 /30/2015 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 50,000 MED EXP(My one person) $ 5,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE GEN'L AGGREGATE POLICYPRO LIMIT APPLIES PER: LOC PRODUCTS-COMPIOP AGGX A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS HIRED AUTOS X NON -OWNED AUTOS PP0101471-04 /30/2014 /30/2015 MBINED SINGLE LIMnEa aocidenl 02�',O BODILY INJURY (Per person) BODILY INJURY Per accidentAUTOS ( )X PROPERTY DAMAGE Per accident UMBRELLA LIAR EXCESS LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEC) I I RETENTION $ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, descrii,e under DESCRIPTION OF OPERATIONS Below N/A 032913 /1/2013 /1/2014 X I WC STATU- OTH- E.L. EACH ACCIDENT $ 100,000 E. L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE- POLICY LIMIT 1 $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if mom space is required) Certificate holder is named as an Additional Insured. City of Fort Collins Purchasing Division P.O. Box 580 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 ACORD 25 (2010105) Swanson/CARLIE © 1988-2010 ACORD CORPORATION. All riahts reserved- INS025 (201005).01 The ACORD name and logo are reqistered marks of ACORD