Loading...
HomeMy WebLinkAbout100753 AQUATICS ASSOCIATES INC - INSURANCE CERTIFICATE (8)AQUAT-1 OP ID: P5 ACOROA P ATE (MM/DDIYYYY) �� CERTIFICATE OF LIABILITY INSURANCE TE(MM/ DfYY 016 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 NAME: House Account Brown & Brown Inc PHONE FAX 4532 Boardwalk Dr, Suite 200 WINE Ext:970-482-7747 A/C, No: 970-484-4165 Fort Collins, CO 80525 E-MAIL House Account ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A:PInnacol Assurance Company 41190 INSURED Aquatics Associates, Inc. INSURER B : Scottsdale Insurance Company 41297 Tami Schneck INSURER C: Hartford Underwriters Ins Co 30104 3013 E Mulberry St Ft Collins, CO 80524 INSURERD: INSURER E : INSURER F : rfAVFRA(:FC r1=PTIFI('ATF NI IMRFR• RFVICION 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 ADDL UBR POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS B X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X CPS2590408 01/01/2017 01/01/2018 EACH OCCURRENCE $ 1,000,00 DAMAGETO RENTED PREMISES Ea occurrence 100 00 $ � MED EXP (Any one person) $ 5,00 PERSONAL & ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JECT PRO ❑ LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 1,000,00 $ C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED X SCHEDULED AUTOS AUTOS X X NON -OWNED HIRED AUTOS AUTOS X 34UECAQ4574 01/01/2017 01/01/2018 COMBINED SINGLE LIMIT Ea accident $ 1,000,00 $ $ $ ' BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE Per accident UMBRELLA LIAB EXCESS LIAR OCCUR CLAIMS -MADE NOT COVERED EACH OCCURRENCE $ AGGREGATE $ DIED I I RETENTION $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? ❑ (Mandatory In NH) If yes, describe under DESCRiPTION OF OPERATIONS below N / A 2218672 01/01/2017 01/01/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT is 500,00 E.L. DISEASE - EA EMPLOYEE $ 500,00 E.L. DISEASE - POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) jstephen fcgov.com 970-221- 77 (_FRTIFIrATF Hr11 nFR (_ANrFI I ATInN CITFORT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Purchasing John Stephen AUTHORIZED REPRESENTATIVE House Account 215 North Mason Fort Collins CO 80524 © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD AQUAT-1 PAGE 2 NOTEPAD INSURED'SNAME Aquatics Associates, Inc. OP ID: P5 Date 12/20/2016 n required by written contract the following applies: lanket Additional Insured - GLS150 07-06 lanket Additional Insured - Automobile-HA9916 03-12