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CORONA SIERRA COLORADO INC DBA CORONA CO INC - INSURANCE CERTIFICATE
Client#: 60361 FITerel :T1111141 d ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 3/23/2015 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 endorsement(s). PRODUCER Willis of Colorado, Inc. 2000 South Colorado Boulevard Tower II, Suite 900 Denver, CO SO222 CONTACT NAME: Jeri Frickey PHONE 720-974-2715 " 720-524-0130 AIC No Ext : A/C, No EMAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC# INSURER A: Colony Insurance Company 39993 INSURED Corona Sierra Colorado, Inc. dba Corona Co, Inc. P.O. BOX 54 INSURER B: INSURER C: INSURER D Larkspur, CO 80118 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 CONTRACTOR 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. LTRR TYPE OF INSURANCE IN RL y yD POLICY NUMBER MMILDICDY EFF MMIDO EXP UNITS A GENERAL LIABILITY 000000172550 3/20/2015 03i=201116 EACH OCCURRENCE $1 000000 X COMMERCIAL GENERAL LIABILITY PREMISES EaEo TurtOence $100 0UO CLAIMS -MADE 19 OCCUR MED EXP (Any one person) $5 000 PERSONAL B ADV INJURY $1,000,000 X PD Ded: 5,000 AI#U1560(03-10) GENERAL AGGREGATE $2,000,000 X GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2,000,000 POLICY X P CT LOCI I $ AUTOMOBILE LIABIIJ COMBINED SINGLE LIMIT Ea accident BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTYDAMAGE (Par aa9don [ $ NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAR EACH OCCURRENCE $ HOCCUR AGGREGATE $ EXCESS LIAB CLAIMS -MADE DED RETENTION$ $ COMPENSATION - OTH- WC STATUY FIR LIMIWORKERS AND EMPLOYERS' LIABILITY Y I N ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory in NH) If yes, tlescnbe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: License License Number: C7-214 The following are Additional Insureds as respects General Liability only if required by written contract and coverage applies only as (See Attached Descriptions) City of Fort Collins P.O. Box 580 Fort Collins, CO 80524 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 M ACORD 25 (2010/05) 1 of 2 #S11434661M1142873 © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 8DDIX DESCRIPTIONS (Continued from Page 1) respects ongoing operations performed by the Insured for the Additional Insureds. Additional Insureds: City of Fort Collins All coverage terms, conditions and exclusions of the policy apply. The Additional Insured endorsement which is referenced above under "Type of Insurance -General Liability" is attached. SAGITTA 25.3 (2010/05) 2 of 2 #S1143466/M1142873