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Home My WebLink AboutQUINN MCELWEE - INSURANCE CERTIFICATE (2)A� " CERTIFICATE OF LIABILITY INSURANCE DATE(MM/OD/1^ 8/7/2019 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 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 Leavitt Recreation 6 Hospitality Insurance, Inc. 942 14th Street Sturgis SD 57785 NAME: Shawna Royer PHONE (800)525-2060 A/� No: (e66)665-2]9] A/C No Ez E-MAIL shawna-royer@leavitt.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC 0 INSURER A:Auto -owners Insurance CompanyCompairty 18988 INSURED Quinn McElwee 10555 CR 13 Wellington CG 80549 INSURER B : INSURER C: INSURER D: INSURER E : INSURER F: rnVFRArFS CERTIFICATE NUMBER:CL198718178 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 ADOL SUBR POLICY NUMBER POLICY EFF MM/DONYYY POLICY EXP MM/DD/YYVV LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S CLAIMS -MADE ❑ OCCUR DAMAGE TO RENTED PREMISES Ea occurrence S MED EXP (Any one person) $ PERSONAL BADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGO $ POLICY El PRO- ❑ LOC JECT OTHER: AUTOMOBILE LIABILITY' COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ 100,000 A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS X 51-559956-00 12/27/2018 12 /27 /2019 BODILY INJURY (Par accident) $ 300,000 PROPERTVDAMAGE Per accident $ 100, 000 Uninsured motobst 81 split limit $ 100,000 X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 A EXCESS LIAB CLAIMS -MADE DED I X I RETENTION $ 1$ X 51-554956-01 8/7/2019 8/7/2020 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED7 ❑ (Mandatory In NH) N / A PER OTH- STATUTE ER E.L. EACH ACCIDENT S E.L. DISEASE- EA EMPLOYEE $ E.L. DISEASE- POLICY LIMIT $ It yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORO 101, Additional Remarks Schedule, may be attached if more space is required) IT IS UNDERSTOOD AND AGREED THAT THE CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED, BUT ONLY WITH RESPECT TO ITS LIABILITY ARISING OUT OF THE ACTIVITIES OF THE NAMED INSURED. UrM I Irlt.,A I C rIULUCIN City of Fort Collins, CO PO Box 580 Fort Collins, CO 80522 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 Petty/SOAGA —TD a.--- v` *— ACORD reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD INS025 (201401)