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HomeMy WebLinkAboutLEWIS TENNIS LLC - INSURANCE CERTIFICATE (8)To: Page 2 of 2 28/07/2015 17:20:39 CDT 18668718451 From: Christi Nistler A0 DATE (MMIDDNYYY) f-kft CERTIFICATE OF LIABILITY INSURANCE 7/28/2015 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 CONTACT C.L Central NAME: Ewing -Leavitt Insurance Agency PHONE (970) 6 7 9 - 7 3 3 3 FAX - (866)456-4265 4025 St. Cloud Dr. E-MAIL A)DRESS: Suite 100 INSURER(S) AFFORDING COVERAGE NAIL# Loveland CO 80538 tNSURERA:AtltO Owners 18988 INSURED _. _... .. _ INSURERS: Lewis Tennis LLC INSURER C: P O BOX 1207 INSURER0: Laporte CO 80535 1 INSURER F: I I C0VFRAGFR CFRTIFICATF NUMBFR-15/16 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 ADDLSUBR POLICY NUMBER POLICY EFF MMIDD/YYVV POLICY EXP MM100fYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR 74687368 7/15/2015 7/15/2016 DAMAGE TO RENTED _PRQ1 ES t taoccurrence S 50,000 MED EXP (Ary one person) S 5,000 PERSONAL 8 ADV INJURY S 1,000,000 GENERAL AGGREGATE S 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPfOP AGG S 2,000,000 S ECT X POLICV PRO LOC AUTOMOBILE LIABILITY COMBINEDtSINGLE LIMIT 1,000,000 BODILY INJURY (Per person) S Ix ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS 74687368 7/15/2015 7/15/2016 BODILY INJURY (Per accioent) S PROPERTY DAMAGE Per ac=.111 S NON -OWNED HIRED AUTOS X AUTOS S UMBRELLA LIAB 177_1O_.s_TAADE EACH OCCURRENCE 5 AGGREGATE S EXCESS LIAB DED RETENTION S S WORKERS COMPENSATION AND EMPLOYERS LIABILITY YIN WC STATU- OTH- T LIMIT R E.L. EACH ACCIDENT S ANY PROPRIETORIPARTNER,EXECUTIVE OFFICERWEMBER EXCLUDED? ❑ N/A E.L. DISEASE -EA EMPLOYE 5 (Mandatory In NH) If )•es. describe uncer DESCRIPTION OF OPERATIONS below -.—._. ._.. E.L. DISEASE - POLICY LIMIT ......_._...__._...................._._.._.......... I S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Fort Collins is named as an Additional Insured as per written contract. lqq illiNl_\I=z;L§1q qV (970)221-6782 City of Fort Collins 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 zcNistler/CANIST ACORD 25 (2010105) (D 1988-2010 ACORD CORPORATION. All rights reserved. INS025;2oioot)o1 The ACORD name and logo are registered marks of ACORD