HomeMy WebLinkAbout427002 MARTIN VERMILYEA DBA HERITAGE FARMS - INSURANCE CERTIFICATE (3)BURM
REAU
INEURAWE
i+
Evidence of Insurance
Additional Interest
Interest
90217950
CITY OF FT COLLINS
215 N MASON ST
FT COLLINS, CO 80524
Policy Number CS217950-5
Amended Date 03/09/2017
Named Insured
VIOLA VERMILYEA
MARTY VERMILYEA
4412 STABLE LN
FORT COLLINS, CO 80525
Effective Date 03/09/2017
Expiration Date 03/09/2018
This form is not the contract of insurance. It is a memorandum of coverage limited to the interest and applicable to the item below.
Liability
Risk#
Coverage
Limits of Liability
Legal Location
Each Person
Each
Occurrence
15
Combined Single Limit
NC* 600,000
19 ACRES AT TWSP 06 RNG 68
LARIMER, CO
15
Medical Payments To Others
5,000 50,000
34 ACRES AT TWSP 07 RNG 68
LARIMER, CO
15
Fire Legal Liability (Farm Structures)
NC* 50,000
17 ACRES AT TWSP 07 RNG 68
LARIMER, CO
I Hklmr-o M I I VVJr U/ r1\IVl7 00
LARIMER, CO
Your interest in risk(s) 15 is as a Lessor -additional insured.
Coverage is restricted to this relationship.
*NC = No Coverage
Agent's Name MICHAEL LEFFLER
Agent's Address 335 E. MOUNTAIN AVE.
FORT COLLINS, CO 80524
Agent's Phone # (970) 482-3952
Date 01 /28/2017
6873115 Colorado Farm Bureau Mutual Insurance Company Pg. 1
9177 E. Mineral Circle, Centennial, CO 80112