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HomeMy WebLinkAbout490634 DOUGLAS B HOLT & TUBA USTUNER - INSURANCE CERTIFICATE (5)HOLTD-1 OP ID: CS , 1114 O CERTIFICATE OF LIABILITY INSURANCE DATE 20/2015 Y) �� 04/20/2015 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 NAME: Cheryl SOS _ GIA Group/Glenwood Ins. Agency PHg70-945-9161 (FaAc.Not: 970-945-6027 P O Box 1270 (A/c.ONE No EXt1: Glenwood Springs, CO 81602-1270 E-MAIL DRESS: cheryls@glenwoodins.com Cheryl SOS _ INSURER A:Central Insurance Companies _ INSURED Douglas B. Holt &Tuba INSURER B: 2945 Juilliard St. INSURER C: Boulder, CO 80305-7035 INSURER D : INSURER E : INSURER F : f^nVFlaAr-Fc 11FRTIFICATF NUMRFR_ 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 TYPE OF INSURANCE ADDL, U LTR POLICY NUMBER MM/D EFF MM/DDY EXP LIMIT A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,00 �I CLAIMS -MADE -- OCCUR X CLP02263015113 04/03/2015 04/03/2016 t _ 500,00 DAMAGE 0 RENTED PREMISES Eaoccumance MED EXP (Any one person) $ 5,00 PERSONAL B ADV INJURY S 1,000,00 GENERAL AGGREGATE S 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,00 X POCV PRO 71 LOC ECT S OTHER AUTOMOBILE LIABILITY COMB NEDISINGLE LIMIT S BODILY INJURY (Per person) ANY AUTO 3 BODILY INJURY (Per accident) ALL OWNED SCHEDULED S AUTOS NON -OWNED J AUTOS PROPERTY DAMAGE Per accident S HIRED AUTOS AUTOS S UMBRELLA LIAR OCCUR EACH OCCURRENCE S 1,000,00 AGGREGATE $ A EXCESS LIAR CLAJMS-MADE CXS02263015114 04/03/2015 04/03/2016 Tom_ DED RETENTIONS $ WORKERS COMPENSATIONPER STAT TE ER AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERiEXECUTIVE E.L. EACH ACCIDENT s OFFICERIMEMBER EXCLUDED? (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYE_ S It yes, aesu lu, vndei DESCRIPTION OF OPERATIONS belax E.L. DISEASE -POLICY LIMB S A Property Section CLP02263015113 W0312015 04/03/2016 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is named as additional insured. RE:221-227 Jefferson, Fort Collins, CO CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins Utilities ACCORDANCE WITH THE POLICY PROVISIONS. 117 N Mason St. Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE 1' 116 of © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD