Loading...
HomeMy WebLinkAbout107133 BATH INC - INSURANCE CERTIFICATE (9)ACCOR®® CERTIFICATE OF LIABILITY INSURANCE L.i' DATE (MM/DDIYYYM) 10/23/2019 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(les) 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 —EN - NAME:- CONTACT JBODIfer Winter, CISR PHONE (970) 508 3206 970) 506-6846 E41,A/C No : Flood and Peterson ADDRESS: JWinter oodp eterson.00m _ -- PO Box 578 INSURER(Si AFFORDING COVERAGE NAIC 0 INSURERA: Union Insurance C ompany 25844 Greeley CO 80632 INSURED INSURERB: Pmnacol Assurance 41190 INSURERC: Bath, Inc. INSURER D: 2000 E. Prospect Road INSURER E : INSURER F: Fort Collins CO 80625 COVERAGES CERTIFICATE�NUMBER! CL19102332031 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. LTR TYPE OF INSURANCEIMAM POLICYNUMBER fMWDONYrn IMWI)DNYYY)LIMITS COMMERCIALGENERALLLIBILIN EACH OCCURRENCE E 1,000,000 CLAIMS -MADE ©OCCUR PREMISES Eapcaaiance $ 300,000 x MED EXP (Any one pwm) $ 10,000 PD Ded:500 PERSONAL& ADV INJURY $ 1.,000,000 A CPA3152084-23 11/012019 11/01/2020 GEN'LAGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 2,000.000 POLICY ® JEcT ® LOC PRODUCTS-COMP10PAGG $ 2,000,000 E OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY IN JURY Per parson) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS. CPA3152084-23 11/012019 - 11/012020 BODILY INJURY( Per acddaM) t PROPERTY DAMAGE Per wddent $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY H E DOC UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 5,000,000 AGGREGATE E 5,000,000 A EXCESSLUB CLAIMS -MADE CPA3152084-23 11/012619 11/012020 DEC) I X RETENTION .$ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETORIPARTNERIEXECUfIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatary In NH) NIA 4015110 11 /012019 11/012020 PR STATUTE ER - E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 If yes. descibe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT E 1,000,000 - - - - - bESCRIPnDN OP OPERATKNS I LOCATIONS I VEOCLES (ACORD 101, Additional Remarks Schedule, alay.be atiaeheA If more apace is riio ea) - RE: Downtown Hotel City of Fort Collins, its officers, agents, and employees are listed as Additional Insureds as respects General Liability, including completed operations, and Auto Liability. Insurance is primary and non-contributory. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE.POLICY PROVISIONS. PO Box 580 _ - AUTNOR�D REPRESENTATIVE Fort Collins CO 80522 (� ®1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD