HomeMy WebLinkAboutJ.P. LEGEL INC DBA A WANDERLUST ADVENTURE - INSURANCE CERTIFICATE (3)A`COR�® CERTIFICATE OF LIABILITY INSURANCE
7DATE,(MM/DDIYYYY)
/05/2018
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 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
CT
NAME: Denise Leeper
PH(208) 743-9426 A C, No : (208) 748-9433
A/C ONE No Ext :
CBIZ Sattler Insurance
E-MAIL dleeper@cbizsattler.com
ADDRESS:
1504 8th St
INSURERS) AFFORDING COVERAGE
NAIC #
INSURER A : Tudor Insurance Company
37982
Lewiston ID 83501
INSURED
INSURER B :
INSURER C :
J.P. Legel, Inc., DBA: A Wanderlust Adventure
INSURER D :
3500 Bingham Hill Rd.
INSURER E :
INSURER F :
e t. Collins CO 80521
COVERAGES CERTIFICATE NUMBER: 18-19 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.
IN
TR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
It"
MM/DDAUULSUBR Y/YYYY
POLICY EXP
MM DD/YYYY
LIMITS
x
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE F OCCUR
DAMAGE TO REN 11:17-
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 2,500
A
Y
PGP0893920
06/08/2018
06/08/2019
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS-COMP/OP AGG
$Included
POLICY PRO
JLOC
Non -owned
s 500,000
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$
BODILY INJURY (Per person)
$
ANY AUTO
BODILY INJURY (Per accident)
$
OWNED SCHEDULED
AUTOS ONLY AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAR
CLAIMS -MADE
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE --I
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
N / A
PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
E.L. DISEASE - POLICY LIMIT
$
If yes, describe under
DESCRIPTION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space Is required)
The certificate holder is an additional insured for general liability only with respects to the ongoing operations of the named insured.
Landowner
GtK I IYIL:A I t HULUtK I evil
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Natural Areas Department ACCORDANCE WITH THE POLICY PROVISIONS.
1745 Hoffman Mill Rd.
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522-0580 K 1�iurwr}�
U 19t S-ZU1 b AL:UKU GUKVUKA I IUN. All rlgnis reserveo.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD