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ST PETERS FLY SHOP LLC - INSURANCE CERTIFICATE (2)
STPET-1 OP ID: CD ATE (MMIDDIYYYY) ,acoRO CERTIFICATE OF LIABILITY INSURANCE 02/17/2016 02/17/201 s 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: CONTACT Michelle R. Jaramillo Outdoor Insurance Group, Inc. PHONE FAX 1371 Hecla Drive Ste E A/C No Eat:303-951-5050 ac No): 303-951-5060 Louisville, CO 80027 E-MAIL Glenn J. Sudol ADDRESS: INSURER A: New Hampshire Insurance Co 23841 INSURED St. Peters Fly Shop, LLC INSURERS: Grant & Julia Houx 202 Remington St. INsuRERc: Ft. Collins, CO 80524 INSURERD: INSURER E : INSURER F : C0VFROGFS CFRTIFICATF NIIMRFR- RFVIRIAN NIIMRFR- 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 POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE I " - OCCUR X AIP0001258003602 03/08/2015 03/08/2016 EACH OCCURRENCE $ 1,000,000. DAMAGE TO RENTED PREMISES Ea occurrence 30O OO $ , MED EXP (Any one person) $ PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JE LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Peraccident $ UMBRELLA LIAR LIAR OCCUR CLAIMS -MADE EACH OCCURRENCE $ ElEXCESS AGGREGATE $ $ DED i I RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A PER OTH- STATUTE ER $ E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE _- $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) It is understood and agreed that the Certificate Holder is named as Additional Insured, but only with respect to it's liability arising out of the activities of the Named Insured. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Ft. Collins Natural Areas ACCORDANCE WITH THE POLICY PROVISIONS. 1745 Hoffman Mill Road PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80522 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD