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HomeMy WebLinkAboutRocky Mountain Recreation Inc - Insurance CertificateROCKMOU-09 EBIELKIEWICZ ACORO" 1 DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 0$/10/2017 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 Paula Weeks Forsberg EngerSherman t Co A/C, o, Ext): (303) 762-1717 FAX No :(303) 762-1733 3575 S Sherman St Englewood, CO 80113 EMAIL : paula@forsberg-engerman.com INSURED Rocky Mountain Recreation Inc PO Box 620411 Littleton, CO 80162 INSURER A : Cincinnati,' INSURER B: The CInc INSURER C : Eyanstoi INSURER D: Pinnacol INSURER E : INSURER F : Underwriters Insurance Company 113037 ce rnX1P0An=Q r F=PTIC1rATF All IMRFR• RF\/ICI(1 AI All IMRGG• iIPill 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 T TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE C.' OCCUR CS00040682 08/10/2017 08/10/2018 EACH OCCURRENCE $ 1,000,000 DAMIAGETOR(EaENTED $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY 7XI JE� D LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 B AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X A&TO ONED EBA 0178279 08/10/2017 08/10/2018 (CEO, accciden SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) BODILY INJURY Per accident $ PROPERTY DAMAGE er accident (Per. $ C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE MKLV5EUL100108 08/10/2017 08/10/2018 EACH OCCURRENCE $ 5,000,000 X AGGREGATE $ DED I RETENTION $ Aggregate $ 5,000,000 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROP RIETOR/FARTNER/EXECUTIVE ❑ (MWFICER/MEMBER EXCLUDED? andatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 4189358 08/01/2017 08/01/2018 X PEA OTH- ER I E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 B Stored Materials !EBA 0178279 08/10/2017 08/10/2018 300,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate holder is Additional Insured as respects Auto Liability and General Liability. The insurance evidenced by this Certificate will not be cancelled or materially altered, except after ten (10) days written notice has been received by the City of Fort Collins. L;tK I IFIL:A I t City of Fort Collins P.O. 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. AUTHOR9F;-- ZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD