HomeMy WebLinkAbout332904 JAG'S ENTERPRISES, INC - INSURANCE CERTIFICATEA� CERTIFICATE OF LIABILITY INSURANCE DAT9(z5/2019
D YYY)
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: It 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 ONTACT
NAME; Katie Smothers
Commercial Risk Solutions-ar+one FAX
6600 E Hampden Ave Ste 200 303-996-7801 A/c 140303-757-7719
Denver CO 80224 ADDAI es : ksmothers cmdenver.com
INSURED
Jag's Enterprises, Inc.
7951 VV 28th Street
Greeley CO 80634
GUVtHAUIzb GtH 11FIL:AIt NUMtStH: 447628607 Mt111,I51UN NUMCGH:
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 TYPE OF INSURANCE---- ,A . i-iR� .--_.__-__- .. POLICY EFF , POUCY EXP
— — — —
LTR POLICY NUMBER MM/DDlYYV D/YY UNITS
A X COMMERCIALGENEFIAALLLtABUJTY Y 1MP19010105 1I272019 11272020 EACH OCCURRENCE 51.000,000
CLAIMS -MADE .J OCCUR :PREMISES (Ee occurrence S100,0DO
L AGGREGATE LIMIT APPLIES PER.
POLICY X JEo LOC
A
AUTOMOBILEUABILrTY
X ANY AUTO
OWNED SCHEDULED
AUTOS ONLY El AUTOS
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
UMBRELLA L!"
OCCUR
EXCESS LIAR
11
MPIDDIO105
Is
1127/2019 11272020 OMa=SINGLE LIMIT 51.000.000
Saocd e11 _
BODILY INJURY (Par person) $
. BODILY INJURY (Per aotiden0 s
PROPERTYDAMAGE
(Per acciden _
$
S
EACH OCCURRENCE
S
6
WORKERS COMPENSATION
(
4146867
6112019
6/12020 iX i STATUT ERA
AND EMPLOYERS' LIABILITY Y i N
ANVPROPRIETORPARTNER'EXECUTIVE
FT] NIA,
IE.L.EACH ACCIDENT
$1,000,000
OFFICER/MEMSEREXCLUDED?
(Mandatory In NH)
E.L. DISEASE - EA EMPLOYEE
$1,000,000
It yes, descrioe under
DESCRIPTION OF OPERATIONS below
I
i DISEASE - POLICY LIMIT
s 1,0D0.000
C Leased and Rented Equipment
i
ILM0707058
127!2019
1/2712020 Limit
50,000
Special ForrNACV180%Coinsurance
Deductible
1,000
i
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101. Additional Remarks Schedule, maybe attached It more space is required)
RE: Poudre Trail Spur at Lancer Drive
City of Fort Collins is included as additional insured on the General Liability with respect to ongoing and completed operations of the named insured for the
Certificate holder as required by written contract. All policy terms, conditions and exclusions apply.
III
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Fort Collins
300 Laporte Ave AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522 U
ACORD 25 (2016/03)
(c) 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
204 34916