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Home My WebLink AboutGREENSHIRE STABLES LLC - INSURANCE CERTIFICATE (5)GREEST OP ID: KP ,a►`4. z CERTIFICATE OF LIABILITY INSURANCE D0912512014/Y) 09/25/2014 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 - 227 Main St - PO Box 190 227M Main St CONTANAME: Rob CarruthGoetz ' PHONE 970.867,8246 FAX No:970-867-4408 ;- ac No Eat E-MAIL ADDRESS: rob.c@goetzinsurors.com - Fort Morgan, CO 80701 Rob Carruth INSURERS AFFORDING COVERAGE _ NAIC fI INSURERA:American Bankers Insurance Co 10111 INSURED Greenshire Stables LLC Craig & Barbara L West Norris 4205 S County Road 7 INSURER B: INSURER C: Fort Collins, CO 80525-9610 INSURER D: NSURER E: NSURER 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 POLICY EFF MM/DD/YYYY POLICY EXP MMIDDIYYYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE rx] OCCUR X FSL4161761 11/15/2013 11/15/2014 EACH OCCURRENCE $ 1,000,00 PREMISES Ea occurrence $ MED EXP (Any one person) $ 5,00 PERSONAL &ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GENT AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 2,000,00 $ MOBILE LIABILITY LLOWNED SCHEDULED AUTOS AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMITEacciden$NYAUTOBODILY INJURY(Per person) $ FAUTOS BODILY INJURY(Per amident )IRE, $ PROPERTY DAMAGE PER ACCIDENT $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE F000010384 11/15/2013 11/15/2014 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DED RETENTION$ $ WORKERS COMPENSATION ANDEMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, desmbe under DESCRIPTION OF OPERATIONS below N/A WC STATU- OTH- V Ik E.L. EACH ACCIDENT $ E.L. DISEASE -EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) The City of Fort Collins is named as an Additional Insured in regards to the General Liability. CITY010 City of Fort Collins Purchasing Departmnet PO 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 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD