HomeMy WebLinkAboutWILDWATER INC - INSURANCE CERTIFICATE (3)ACORI a
CCCERTIFICATE OF LIABILITY INSURANCE
7EJ(MMDDIYYYY)
/25/2018
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
CONTACT Leslie Vannoy, CIC, CRM
NAME:
PHONE (208)743-9426FAX208)748-9433
A/C No Ext : A/C, NO),
CBIZ Sattler Insurance
E-MAIL Ivannoy@cbizsattler.com
ADDRESS:
1504 8th St
INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A : Tudor Insurance Company
37982
Lewiston ID 83501
INSURED
INSURER B
INSURER
Vldwater, Inc, DBA: Al Wildwater
INSURER D
2801 N Shields St
INSURER E
INSURER F
Fort Collins CO 80524
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.
ILTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MM DDYYYYY
MM DD/YYYY
LIMITS
x
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE � OCCUR
PREMISES Ea occurrence
$ 100,000
MED EXP (Any one person)
$ 2,500
A
Y
PGPO893706
01/26/2018
01/26/2019
PERSONAL & ADV INJURY
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS -COMP/OP AGG
Included
$
x POLICY ❑ ECOT LOC
$
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
q
PROPERTY DAMAGE
Per accdent
$
$
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$ _
HCLAIMS-MADE
AGGREGATE
$
EXCESS LIAB
DED RETENTION $
$
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANV PROPRIETOR/PARTNER/EXECUTIVE ❑
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 I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Business Description is rafting, kayak rental & instruction, & raft rental
City of Fort Collins is listed as additional insured with respct to the above mentioned policy
Landowner
It 1'1ULL)CM VMI\VGL IIw IN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS.
424 West Mulberry Street
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80524
U 19BU-2015 ACUKD GUKPUKA I IUN. All rlgnts reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD