HomeMy WebLinkAboutIGNACIOUS VENTURES DBA ROCKY MOUNTAIN ADVENTURES - INSURANCE CERTIFICATE (9)FRO®
A CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/2018 Y)
05/02/018
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
CONTACTDenise Leeper
NAME
CBIZ Sattler Insurance
A/o a o Ext : (208)743-9426 q/C, No : (208)748-9433
E-MAIL dleeper@cbasattler.com
ADDRESS:
1504 8th St
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A : Tudor Insurance Company
37982
Lewiston ID 83501
INSURED
INSURER B : Artisan and Truckers Casualty
10194
INSURER C :
Ignacious dentures, LLC,
INSURER D
DBA: Rocky Mountain Adventures, Mad Adventures
INSURER E
PO Box 1989
INSURER F
Fort Collins CO 80522
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.
INSR
LTR
TYPE OF INSURANCE
AlJIJLbUl3K
INSD
WVD
POLICY NUMBER
P LICY EFF
MM/DD/YYYY
P LICY EXP
MM/DD/YYW
LIMITS
x
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE F OCCUR
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 2,500
A
Y
PGPOS93869
05/12/2018
05/12/2019
PERSONAL BADVINJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
GENERAL AGGREGATE
$ 3,000,000
PRODUCTS - COMP/OP AGG
$ Included
X POLICY jE LOC
Non -owned
s 600,000
OTHER
AUTOMOBILE LIABILITY
CEa acatlOT ent INED SINGLE LIMIT
s 2,000,000
BODILY INJURY (Per person)
$
ANY AUTO
BODILY INJURY (Per accident)
$
B
OSCHEDULED
D WNE
AUTOS ONLY x AUTOS
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
01321088-8
01/23/2018
07/23/2018
PROPERTY DAMAGE
Per accident
$
Uninsured motorist
s 2,000,000
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
HCLAIMS-MADE
AGGREGATE
$
EXCESS LAB
DED I I RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE 7,
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
NIA
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.
Permit
I:NAl]3iB
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 80524
V 1yt5t5-ZU1b AL:UKLJ I:UKNUKA I IUN. All rlgnis reserveu.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD