HomeMy WebLinkAbout125071 ROCKY MOUNTAIN RECREATION INC - INSURANCE CERTIFICATE (3)ROCKMOU-09 CPOPE ACOROP ATE (MM/DD/YYYY) `,� CERTIFICATE OF LIABILITY INSURANCE ;MM/D N 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 CONTANAME: CT Aaron Frye Forsberg Engerman Co PHONE FAX 3575 S Sherman St A/C No Ext : (Arc, No): Englewood, CO 80113 E-MAIL aaron@forsberg-engerman.com INSURER(S) AFFORDING COVERAGE NAIC # _ INSURER A: Cincinnati Specialty Underwriters Insurance Company 13037 INSURED INSURER B:The Cincinnati Indemnity Company 23280 Rocky Mountain Recreation Inc INSURER C: Evanston Insurance Company 35378 PO Box 620411 INSURER D : Pinnacol Assurance 41190 Littleton, CO 80162 INSURER E : INSURER F : COVFRArFS CFRTIFICATF Nl1MRFR- REVISION Nl1MRFR- 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 L INSD UB WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DDNYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE �� X7. OCCUR CS00040682 08/10/2015 08/10/2016 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 � PRO - POLICY LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER. AUTOMOBILE LIABILITY COEa accidentMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) _ $ B X ANY AUTO EBA 0178279 08/10/2015 08/10/2016 ALL OWNED SCHEDULED AUTOS AUTOS $ BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident $ X X NON -OWNED HIRED AUTOS AUTOS UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 X AGGREGATE $ C EXCESS LIAB CLAIMS -MADE MKLV50LE103104 08/10/2015 08/10/2016 DED I X I RETENTION $ 0 Aggregate $ 1,000,00 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N / A 4189358 01/29/2016 08/01/2016 STATUTE ERH E.L. EACH ACCIDENT $ 1,000,00 F_.L. DISEASE - EA EMPLOYE I $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 B Equipment Floater EBA 0178279 08/10/2016 08/10/2016 300,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is Additional Insured as respects Auto Liability and General Liability. The insurance evidenced by this Certificate will not be cancelled or materially altered, except after ten (10) days written notice has been received by the City of Fort Collins. CERTIFICATE HOLDER CANCELLATION City of Fort Collins P.O. 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 d4f_::_ — © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD