HomeMy WebLinkAboutRAM INTERNATINOAL 1 LLC - INSURANCE CERTIFICATECERTIFICA
OF LIABILITY INSURANCE
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 CERTIFIC TE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL. INSURED, the pollcy(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 INTA
NAMEZ J0 Lewis
Arthur J. Gallagher Risk Management Services, Inc. PHONE . 206-566-7340 A/c :425
fAtC- No
M451-3716
P.O. Box 2925 EMAIL
Tacoma WA 98401-2925 ADDRESS: JO - LeWis a' .com
INSURED
Ram international 1 LLC
Attention: Tim Bunch
10013 59th Ave SW
Lakewood WA 98499
Fund Insurance Comr
Automobile Insurance
COVERAGES CERTIFICATE NUMBER:1043929169 REVISION NUMBER:
21849
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 INSURANCE
�POLICYNUMBER
C�yy
MWDDD/Y
p
L DO v
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
USC0159
1200
5/112020
5/1/2021
EACHOCCURRENCE
$1,000.000
CLAIMS -MADE I OCCUR
I PREMISES (Ea occurrence
$100,000
MED EXP (Any oneperson)
$ 5,000
PERSONAL & ADV INJURY
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$2,000,000
POLICY ❑ PRO. �
JECT LOC
PRODUCTS • COMKOP AGG
$ 2,000,000
$
OTHER:
B
AUTOMOBILE LIABILITY
SCV0060
92001
5/1/2020
5/1/2021
Eaec daD SINGLE LIMIT
$1`,000,000
BODILY INJURY (Per person)
$
X ANY AUTO
OWNED X SCHEDULED
AlIT06ONLY AUTOS
BODILY INJURY (Per accident)
$
Pei cc dTY DAMAGE
$.
HIRED x AUTOS ONLY x AUUTOS ONLY
UMBRELLA LAB OCCUR
EACHOCCURRENCE
$
AGGREGATE.
$
EXCESS LIAR CLAIMS -MADE
OED I .RETENTION $.
_ ... -
$:_ -
- .. -.
C
WORKERS COMPENSATION
AND EMPLOYERS' UABILnY
ANYPROPRIETOR/PARTNEPoEXECUTIVE Y❑
WVVC3486191
71112020
7/112021
X STAT TE ER
E.L. EACH ACCIDENT
$1,000,000
OFFICER(MEMSEREXCLUDED7
(Mandatory In NH)
NIA
E.L. DISEASE •. EA EMPLOYEE
$1,000,000
It as. describe under
DESCRIPTION OF. OPERATIONS. below
E.L. DISEASE- POLICY LIMIT
$- 1,0001000
A
LiquoruebAty
Employers Use - Stop Gap
USC015901200
5/12020
511/2021
Each common cause
Aggregate
Each Accident
$1,000,000
$2,000,000
$1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional
RE: C.B. & Potts Location at 1441 E Horsetooth Rd, Fort Collins,
Certificate Holder is an Additional Insured as respects General
Remarks Schedule, may be attached 11 more space Is required)
CO 80525
liability policy, pursuant to and subject to the policy's terms, definitions, conditions and
exclusions.
30 Days Notice of Cancellation, 10 Days for Non -Payment of Premium.
.CERTIFICATE HOLDER I :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.
215 N Mason Street, 2nd Floor
AUTHORIZED REPRESENTATIVE
PO Box 580
Fort Collins CO 80522
01968.2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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