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HomeMy WebLinkAboutSURROUNDINGS LLC - INSURANCE CERTIFICATE (5)_­­81i SURRLLC-01 LPREWITT CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 03/1312017 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). C NTACT PRODUCER PFS Insurance Group PHONE 970 635-9400 FAX, No):(970 635-9401 4848 Thompson Parkway Suite 200 A/N No. Ext : ( ) ) Johnstown, CO 80534 . info@mypfsinsurance.com INSURED Surroundings LLC PO Box 339 Timnath, CO 80547 INSURER F : Co. 114 DCV1CIrl1U Kit 1MRFR- VV YLMVLJ 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 jADDL SUBR' TR TYPE OF INSURANCE POLICY EFF POLICY EX LIMITS POLICY NUMBER MM/ /YYYY M/D /YYYY A X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR X39278 04/01/2017I 04/01/2018 j DAMAGETORENTED PREMISES (Ea occurren $ 300,000 5,000 MED EXP (Any oneperson) $ — 1,000,000 PERSONAL & ADV INJURY $ 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PROJECT GENERAL AGGREGATE $ AGG $ 2,000,000 POLICY LOC PRODUCTS -COMP/OP OTHER: A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT a accident_ $ 1,000,000 X ANY AUTO X39278 04101/2017 04F01/2018 gr ppILY INJURY (Person $ ___ _ BODILY INJURY Per acgdent OWNED SCHEDULED AUTOS ONLY AUTOS $ _ PROPERTY DAMAGE (Per acaden>t____ ___,_�$___ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY A UMBRELLA LIAB X OCCUR 04/01/2017 04/01/2018 EACH OCCURRENCE � $ 1,000,000 1,000,000 X EXCE SS LIAB CLAIMS -MADE X39278 AGGREGATE__. -- _ DIED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N STA lLT OTH__ __ ANY PROPRIETOR/PARTNER/EXECUTIVE EACH ACCIDEN $ _ _ FFICER/MEMBER EXCLUDED? C andato in NH i N / A '�. EE L. DISEASE - EA EMPLOYEE' $ - If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT ! $ A Personal Property X39278 04/01/2017 04101/2018'$500 Deductible j 900,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICA City of Fort Collins PO 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 ia-fi.— ACORD 25 (2016103) © 1983-2015 ACORD GUKF'UKA I IUN. An rlgnTs reservea. The ACORD name and logo are registered marks of ACORD