HomeMy WebLinkAboutGREENSHIRE STABLES LLC / CRAIG AND BARBARA NORRIS - INSURANCE CERTIFICATEA� Rom® CERTIFICATE OF LIABILITY INSURANCE
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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 Marinda Simpson State Farm Insurance
2501 S Letnay Ave, Suite#37
5#a#eFarlfit Fort Collins, CO
!� • 80525
NNiWA TBrooke Rowell
�1� .970-223-78M FAX N 970-223-7800
ADDRESS: brooke@marindasimpson.com A
INSURER(SI AFFORDING COVERAGE
NAIC 4
INSURER A :State Farm Mutual Automobile Insurance Company
26178
INSURED BariTard Lynn Norris 8t H Craig Norris
INSURER B :State Farm Fire and Casualty Company
25143
4205 S County Road 7
Fort Collins, CO
80525
INSURER C :
A
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 VITH 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.
LTR
TYPE OF INSURANCE
Sm
POLICY NUMBER
POLICY EFF
M DDOYYYY
POLICY va
MMIDD
-- -
LIM113
COMMERCIAL GENERAL LIABILITY
_ CLAJMS-MADE L� OCCUR
Farm/RanCh Liability
y
96-B9-P068-1
04l0112015
EACH OCCURRENCE_
i_
DAMAGE PREMISES R occurrence)
04,01,2016 MED EXP (Any ona perwn)
PERSONAL S ADV INJURY
GENERAL AGGREGATE
PRODUCTS -COMP/OP AGG
S 1,000,000
$
X
$ 5.000
_
$
GEN'L AGGREGATE LIMIT APPLIES PER:
PRO-
POLICY ❑ JECT LOC
OTHER:
$
S
$
A
AUTOMOBILE
is
LULBILITY
ANY AUTO
ALL OVNED
AUTOS AUTOSVLED
HIREDAUTOS �OS1M1NED
, lr
I
I
i
212 6203-F01-06B
06,01,2015
1
1210112015
COMBINED i LE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$ 250,000
BODILY INJURY (Per accident)
$ - 500,000
4—
PROPERTY DAMAGE
Per_accid_ent)
is- 100,000
i
M
S
UMBRELLA UA9
11 EXCESS LIAR
OCCUR
CLAIMS -MADE
EACH OCCURRENCE
S
AGGREGATE
__
g
S
DED RETENTIONS
T
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFfCER1rA EMBER EXCLUDED? ❑
(Mandatory In NH)
If yes, describe urger
DESCRIPTION OF OPERATIONS below
NIA
PER O -
STATUTE _..I _ER
E E.L.
EACH ACCIDENT
—
$
E.L. DISEASE -EA EMPLOYEF
_....--.._
E.L. DISEASE - POLICY LIMIT
s
DESCRIPTION OF OPERATIONS f LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is rain ad)
The city of Fort Collins is Additional Insured for General Liability and Automobile Liability.
- � vtrlr��.GLLA 1 RJM
City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
PO BOX 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Fort Collins, CO ACCORDANCE WITH THE POLICY PROVISIONS.
80522
AUTHORIZED REPRESENTAnVE
m 1988-2014 AMRD CORPORATION- All rights rsmarvc.d
ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD 1001486 132849.9 02-04-2014