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Home My WebLink AboutJASKI CORPORATION DBA RC SPECIAL EVENTS - INSURANCE CERTIFICATEOF CERTIFICATE OF LIABILITY INSURANCE A�10/3012018 Y) DATE(MM/018 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 have ADDITIONAL INSURED provisions or 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 CONTACT Jordan Hartman, CISR NAME: Flood and Peterson arc No Ext : (970) 356-0123 (FAX No): (970) 330-1867 E-MAIL JHartman@ftoodpeterson.com ADDRESS: PO Box 578 INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Westfield Insurance Company 24112 Greeley CO 80632 INSURED INSURER B : INSURER C : Jaski Corporation, DBA: RC Special Events INSURER D : 6330 Gunpark Dr INSURER E : INSURER F : Boulder CO 80301 CnVFRAGFS CERTIFICATE NUMBER: CL18102925863 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 ADDLISUBK INSD WVD POLICY NUMBER POLICY EFF MMIDD POLICY EXP MM/DD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 5 1,000,000 CLAIMS -MADE ®OCCUR DAMAGE TO RENTE5_ PREMISES Ea occurrence $ 500,000 MED EXP (Any one person) $ 51000 PERSONAL & ADV INJURY $ 11000,000 A Y TRA008221 G 10/28/2018 10/28/2019 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 5 210001000 PRODUCTS - COMP/OP AGG $ 2,000,000 ❑ PRO- JECT ❑ LOC POLICY PRO - $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED AUTOS ONLY AUTOS ONLY TRA008221G 10/28/2018 10/28/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ 5 UMBRELLA LIAB X OCCUR EACH OCCURRENCE 5 1,000,000 A EXCESS LIAB CLAIMS -MADE TRA008221G 10/28/2018 10/28/2019 AGGREGATE $ 1,000,000 DEO L I RETENTION $ 0.00 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN PER OTH- STATUTE ER ANY PROPRIETORlPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? N / A E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT 5 If yes, describe under DESCRIPTION OF OPERATIONS below I DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate holder is included as Additional Insured as required by written contract with respects to liability arising out of work performed by the named insured. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 1580 AUTHORIZED REPRESENTATIVE Fort Collins CO 80522 ILL 1&6 U 1988-2015 AGUKD GUKPOKAI Ivry. AN ngnts reservea. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD