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HomeMy WebLinkAboutGREENSHIRE STABLES LLC - INSURANCE CERTIFICATE (6)GREEST OP ID: KP ,411% o CERTIFICATE OF LIABILITY INSURANCE lono/zola D10/10/20/14 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 endorsements . — PRODUCER Goetz lnsurors,Inc. 227 Main St - PO Box 190 CONTACT Rob Carruth - - PHONE 970-867-8246 FAX A/c No Eat :(A/C,No : 970-867d408 Fart Morgan, CO 80701 Rob Carruth ADDRESS: rob.c@goetzinsurors.com - - - - INSURERS) AFFORDING COVERAGE NAIC a INSURERA:American Bankers Insurance Co 10111 INSURED Greenshire Stables LLC Craig & Barbara L West Norris 4205 S County Road 7 INSURER B: 1INSURER C: Fort Collins, CO 80525-9610 INSURER D: INSURER E NSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NIIMRFR- 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 rypE OF INSURANCEADDL Sulam POLICYNUMBER POLICY E MMIDDNYYY POLICY EXP MM/DDIYYYV LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE O OCCUR X FSL4161761 11/15/2014 11/15/2015 PREMISES Ea occurrence $ MED UP (Any one person) $ 5,00 PERSONAL B ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ 2,000,0U GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2,000,00 POLICY PRO LOC $ - - AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident _ BODILY INJURY(Per person) $ - ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY Par acciderd ( 1 $ HIRED AUTOS NON -OWNED AUTOS PROPERTVDAMAGE PER ACCIDENT $ E X 4 UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 A EXCESSLIAB CLAIMS -MADE X F000010384 11/15/2014 11/15/2016 DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE OFRCERIMEMBER EXCLUDED? N/A E.L. EACH ACCIDENT E E.L. DISEASE- EA EMPLOYE $ (Mandatory in NH) If ea, desaiee under y E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS Uef. DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace la required) The City of Fort Collins is named as an Additional Insured in regards to the General Liability. City of Fort Collins Purchasing Departmnet PO Box 580 Fort Collins, CO 80522 CITY010 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI2E0 REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 The ACORD name and logo are registered marks of ACORD All rahts reserved