No preview available
HomeMy WebLinkAbout118458 FORT COLLINS ARCHERY ASSOCIATION - INSURANCE CERTIFICATEFORTC-5 OP ID: KJ ACORO` CERTIFICATE OF LIABILITY INSURANCE DATE(MWDDNYYY) 06/20/2014 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(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 Leavitt Rec. & Hospitality Ins 94214th Street Sturgis, SO 57785 CONTACTNAME' Chris Hippie PHONE FA% A/c a E,d : 800-525-2060 A/c Ne : 866-063-2797 nooRess: Chris -hi le leavitt.com Chris Hippie INSURERS AFFORDING COVERAGE NAICd INSURER A: Capitol Indemnity Corporation 10472 INSURED Fort Collins Archery Associati P.O. Box 270493 Fort Collins, CO 80525 INSURER 8: INSURER C: 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 A C SUBS POLICY NUMBER MMIDDL YIYYYY MMID YIYYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 CLAIMS -MADE [Ki OCCUR X CP02260043 07/01/2014 07/01/2015 PREMISES Ea=urrence $ 100,000 MED EXP (Any one person) $ 6,000 PERSONAL$ ADV INJURY $ 1,gO0,00 GENL AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE $ 2,000,000 X POLICY PRORO- ❑ LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea eccitlenl $ BODILY INJURY )Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS H BODILY INJURY (Per accident) $ DAMAGE $ AWNED DPeOeoatlen HIRED AUTOS AUTOB $ d UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED I I RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTNE PER OTH- STATUTE ER E.L. EACH ACCIDENT $ OFFICERNEMBER EXCLUDED? F-1 NIA E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Romance Schedule, may be attached If more space is required) IT IS UNDERSTOOD AND AGREED THAT THE CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED, BUT ONLY WITH RESPECT TO ITS LIABILITY ARISING OUT OF THE ACTIVITIES OF THE NAMED INSURED. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CI of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins, CO 80521 AUTHORIZED REPRESENTATIVE Chris Hippie © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014/01) The ACORD name and logo are registered marks of ACORD