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Home My WebLink AboutSPORT COURT OF THE ROCKIES LLC - INSURANCE CERTIFICATE (2)A ® DATE (MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F8/18/2017 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 endorsements . PRODUCER CONTACT NAME: Arthur J. Gallagher Risk Management Services, Inc. PHONE . 303-444-4666 FAX 303-444-8481 3005 Center Green Drive Suite 120 E-MAIL Boulder CO 80301 AD INSURERS AFFORDING COVERAGE NAIC # INSURER A:Travelers Property Casualty Co of America 25674 INSURED SPORCOU-01 INSURERB:Travelers Casualty Insurance Co of America 19046 Sport Court of the Rockies LLC INSURER c:Travelers Indemnity Company 25658 5740 E. County Line Place #2 INSURER0:Pinnacol Assurance Company 41190 Highlands Ranch CO 80126 INSURER E : INSURER F : r�uroAr-Ec rrortrtrAYE nutaacro. 19cigQ1nn16 DElnCtntu NIIMRFD• 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 15 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 POLICY NUMBER POLICY EFF WDDIYYYY POLICY EXP MMIDDIYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X❑ OCCUR 16601CO06885TIL17 5/24/2017 5/24/2018 EACH OCCURRENCE $1,000,000 DAMAG --TO-RENTED PREMISES Ea occurrence $300,000 MED EXP (Any one son) $5,000 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY � PEC LOC OTHER: GENERAL AGGREGATE $2,000,000 PRODUCTS - COMP/OP AGG $2,000,000 $ B AUTOMOBILE uAeiuTv ANY AUTO X OWNED X SCHEDULED AUTOS ONLY AUTOS HIRED NON -OWNED X AUTOS ONLY X AUTOS ONLY BA1 C00737217SEL 5/24/2017 5/2412018 Ea accident $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident)$ $ C UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CUPlCO0781 Al 742 5/24/2017 5/24/2018 EACH OCCURRENCE $2,000,000 X AGGREGATE $2,000,000 DED I X I RETENTION$5,000 $ D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) It yes, describe under DESCRIPTION OF OPERATIONS below NIA 4158255 9/1/2017 9/1/2018 X 1 PI OTH- STATUTE ER E.L. EACH ACCIDENT $11000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 $1,000,000 E.L. DISEASE- POLICY LIMIT A Equipment 16601CO06885TIL17 5J24J2017 W1411018 Rented/Leased $150,000 Deductible $500 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Project: 8498 Tennis Court Maintenance & Renovation On -Call rCDTll:irATG LJni nFD CANCFI I ATInN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins Financial Services, Purchasing Division THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215 N. Mason Street, 2nd Floor PO Box 580 Fort Collins CO 80522 USA AUTHORIZED REPRESENTATIVE U (9) 1988-Z015 ACUKU GUKNut<A I lulu. All rights reserves. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD