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HomeMy WebLinkAbout260459 PLAY POINTE LLC DBA FORT FUN - INSURANCE CERTIFICATE (3)ACII CERTIFICATE OF LIABILITY INSURANCE DATE (MM DD YYVV) �/ 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 riqhts 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 PLAYPCI-C1 Play Pointe. LLC dba Fort Fun 1513 E. Mulberry Fort Collins CO 80524 INSURER O i_ INSURER E : CCIVFRAnFS CFRTIFICATF NIIURFR• 1�nlannnla 01:11ICIrlA1 MIIMRFR- 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. —__ INSR _60— UBR --- u�y PO EFF POLICY EXP LTR TYPE OF INSURANCE WV POLICY NUMBER MWDD/YYYY MMIODIYYYV LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X ,_ OCCUR CPPOID425505 711/2019 7/1/2020 EACHOCCURRENCE PREMIX BE TOR NTED occurrence) MED EXP (Any one person) PERSONAL EADVINJURY GENERAL AGGREGATE PRODUCTS -COMPlOP AGG $1.000,000 $100,000 $ 0 $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JI JECOT LOC OTHER. $2,000,000 $1,000,000 $ A AUTOMOBILE LIABILITY CPP01042S505 7/1/2019 7/1/2020 ANY AUTO OWNED — SCHEDULED AUTOS ONLY _� AUTOS HIRED X NON -OWNED I AUTOS ONLY AUTOS ONLY I I QOMBINED SINGLE LIMIT (.�.4 aG4dant BODILY INJURY (Par person) BODILY INJURY (Per accident) PROPERTY DAMAGE - LPer accident E1.000.000 E E X $ E A X 1 UMBRELLALIAB EXCESS UAB X GCCUR CLAIMS -MADE ELP001167105 7/1/2019 7/1/2020 EACH OCCURRENCE $2,000,000 AGGREGATE E2,000,000 DEC RETENTIONS I $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR PARTNER/EXECUTIVE YiN OFFICEWMEMBEREXCLUDED? NIA (Mandatory In NH) II yes, descripe under DESCRIPTION OF OPERATIONS below 4032913 9/1/20t8 8l1/2018 X - STATUTE ER ELEACH ACCIDENT F L. DISEASE - EA EMPLOYEE E.L. DISEASE- POLICY LIMIT $100,000 $100,000 $500,000 DESCRIPTION OF OPERATIONS LOCATIONS, VEHICLES (ACORD 101, Additional Remarks Schedule, may be atlached it more space is required) Certificate holder Is named as an Additional Insured. L;tH I Ir IL.A I t MULUtH L;ANt.;tLLA I IUN 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 of 3 24,