HomeMy WebLinkAbout282740 SPORT & FITNESS INC - INSURANCE CERTIFICATE (2)12/24/2014 12:03 PM FROM: Fax John C Beckett and Associates TO: 2246134 PAGE: 001 OF 001
ACORO® CERTIFICATE OF LIABILITY INSURANCE
DATE °"
12/24/201/2014
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 pollcy(les) 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
CONIACT
NAME:
JOHN C. BECI@TT 6 ASSOCIATES, INC.
P,1",c°H xR, Ed: (970) 48d-2805 PA%FAXNap ($TO) {8{-2385
220 Smith Street
iDolieae: linda@beckettinsurance.com
PRODUCER P CUBTDAER O Sport 6 Fitness, Inc.
p.
Ft. Collins CO 80524-
INSURER(S) AFFORDING COVERAGE
NAIC/
INSURED
MAURER A :ESSEX INSURANCE CO.
Sport 6 Fitness, Inc.
INSURER 8 :PINNACOL ASSURANCE
1409 Pikes Peak Avenue
INSURER c
NSURER D
NBURER E
Fort Collins CO 80524-
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.
NSR
ADDL
SUOR
POLICY EFF
FOUCY E%P
LTN
ME OF INSURANCE
OVER
WVD
POLICY NUMBER
(MSCOMYYIT
(MI"DOHYWI
UNINS
A
OENERAL UJULRY
3DW32e
2/28/2019
2/28/201S
EACHOCCURRENCE
$ 1,000,000
PREMISES o rr n e
$ 50000
X COMMERCIAL GENERAL LIABILITY
/ /
/ /
CLAIMS -MADE O OCCUR
/ /
/ /
MED EXP (My one person)
$ 1000
PERSONAL 8 ACV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
/ /
/ /
X POLICY PRO- LOC
JECT
/ /
/ /
$
AUTOMOBILE
LU LUM
go COVERAGE
/ /
/ /
COMBINED SINGLE LIMIT
$
ANY AUTO
BODILY INJURY (Per person)
$
PLL OWNED AUTOS
/ /
/ /
cc BODILY INJURY(Per Sidelt)
$
SCHEDULED AUTOS
PROPERTY DAMAGE
$
HIRED AUTOS
/ /
/ /
(Peracadenq
NON-OKNED AUTOS
/ /
/ /
$
/
$
YNERELu LUB
OCCUR
D COVERAGE
/ /
/ /
EACH OCCURRENCE
$
EXCESS LAE
CIAIMSMPDE
/ /
/ /
AGGREGATE
$
/ /
/ /
DEDUCTIBLE
$
RETENTION $
/ /
/ /
$
B
...E.. eDNPENuinx
110269
2/01/2014
2/01/201$
X ' STATU-- OTH-
ANO EMPLOYERS' LUBILRY
YIN
EL EACH ACCIDENT
$ 100,000
MY PROPRIETORRMMEREXECUTNE
/ /
/ /
OFFICERMEMBER EXCWOED2 1-Y I
NIA
/ /
/ /
(Mandatory In NH)
E. L. DISEASE - EA EMPLOYEE
$ 100,000
It yes. OescnOe under
/ /
/ /
DESCRIPTION OF OPERATN)NS to
EL. DISEASE -POLICY LIMIT
$ 500,000
O COVERAGE
DESCRIPTION OF OPERATORS / LOCATIONS I VEHICLES (AR h ACORD 101, Addb" RwaMF SCImKSA, If mom Vue IF "Ovd)
CITY OF FORT COLLINS ITS OFFICERS, AGENTS AND EMPLOYEES ARE LISTED AS ADDITIONAL INSURED ARISING OUT OF THE OPERATIONS
OF THE NAMED INSURED.
(970) 224-6134
PURCHASING DEPT
CITY OF FORT COLLINS
215 N 1ASON 2ND FLOOR
FORT CM ---INS CO 80522-0580
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHOROED REPREBEWATNE
ACORD 25 (7009109) ® 1988.2009 ACORD CORPORATION. All rights reserved.
INSO25 (200809) The ACORD name and logo are registered marks of ACORD