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HomeMy WebLinkAboutCORRESPONDENCE - GENERAL CORRESPONDENCE - INSURANCE,acoRo� CERTIFICATE OF LIABILITY INSURANCE DATE(MMDD.YYYY) 7/26/2019 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 richts to the certificate holder in lieu of such endorsement(s). PRODUCER Arthur J. Gallagher Risk Management Services. Inc. 10901 West 120th Ave. Suite 100 Broomfield CO 80021 INSURED Play Pointe. LLC dba Fort Fun 1513 E. Mulberry Fort Collins CO 80524 PLAYPOI-01 : T.H.E. Insurance C( : Pinnacal Assurance INSURER D :. INSURER E: COVERAGES CERTIFICATE NUMBER:627862026 REVISION NUMBER: 12866 41190 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. INBR —_—_— -_ !A OR _—_____I-POLICY FFF POLICCY EXP --_-- _._—. ___ ._. .—_____ LTRI TYPEOFINSURANCE .I .WV POLICY NUMBER MWDDIYYY Mli (YY LIMITS A X ' COMMERCIAL GENERAL LIABILITY _ CLAIMS -MADE ^X__ OCCUR ` CPP010425505 7/1/2019 711/2020 EACH OCCURRENCE ., PREMISES (Ea occurrence) MED EXP (Any one person) _PERSONAL a ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG $1,000,000 $100,000 $ 0 $1,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: X7 POLICY JEPRCTO F7 LOC OTHER $2,000,000 $1,000,000 $ AUTOMOBILE LIABILITY _ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED AUTOS ONLY X AUTOS ONLNOWOWNEY CPP010425505 7/1/2019 EDSINGELIMIA 7/V2020 jT,acrint BODILY INJURY (Per person) BODILY INJURY (Per accident) �SPer Pa_nE,ctnt,AMAGE $1,000.000 S $ $ A X UMBRELLA LIAB I X OCCUR EXCESS LIAR CLAIMS -MADE DEC RETENTION ELP001167105 7/1/2019 711/2020 EACHOCCURRENCE AGGREGATE 52,000.000 $2,000,000 $ S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ ANYPROPRIETORPARTNERIEXECUTIVE ❑N OFFICERIMEMBER EXCLUDED? (Mandatory In NN) II yes. descibe under DESCRIPTION OF OPERATIONS below �NIA 4032913 1 9/12STATUTE 018 9/1/2019 X ER - _ E.L. EACH -ACCIDENT E L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT $100,000 $100.000 111500,000 I I DESCRIPTION OF OPERATIONS LOCATIONS, VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate holder is named as an Additional Insured. rM City of Fort Collins Purchasing Division P O. Box 580 Fort Collins CO 80522 USA 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 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD 2' of 3 247