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HomeMy WebLinkAboutRONALD TREIBER - INSURANCE CERTIFICATEFARM BUREAU INSURANCE Evidence of Insurance Additional Interest Interest 90203707 CITY OF FORT COLLINS PO BOX 580 FORT COLLINS, CO 80522 Policy Number CS203707-23 Amended Date 04/10/2019 Named Insured RONALD TREIBER PO BOX 1523 LAPORTE, CO 80535 Effective Date 03/25/2019 Expiration Date 03/25/2020 This form is not the contract of insurance. It is a memorandum of coverage limited to the interest and applicable to the item below. Liability Risk# Coverage Limits of Liability Legal Location Each Person Each Occurrence 11 Combined Single Limit NC* 500,000 50 ACRES AT TWSP 08N RNG 69W LARIMER, CO 11 Medical Payments To Others 1,000 10,000 70 ACRES AT TWSP 8N RNG 69W LARIMER, CO 11 Fire Legal Liability (Farm Structures) NC* 25,000 200 ACRES AT TWSP 8N RNG 69W LARIMER, CO Your interest in risk(s) 11 is as a Lessor -additional insured. Coverage is restricted to this relationship. *NC = No Coverage Agent's Name MARK FIRMERY Agent's Address 335 E MOUNTAIN AVE FORT COLLINS, CO 80524 Agent's Phone # (970) 482-3952 Date 04/23/2019 1,000 ACRES AT TWSP 7N RNG 70W LARIMER, CO 7663518 Colorado Farm Bureau Mutual Insurance Company 9177 E. Mineral Circle, Centennial, CO 80112 Pg. 1