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HomeMy WebLinkAboutDowntown Bozeman Association Certificate of Liability InsuranceFrom: Alyssa Raser At: Western States Insurance FaxID: Western States Insur To: cQty of Bozeman Date: 4/72008 04:53 PM Page: 2 of 5 ACORD CERTIFICATE OF LIABILITY INSURANCE OPID Ax DATE (MMlDD1WW) DOWNTI3 04/07/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Western States Ins - Bozeman HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1283 N. 14th Ave, Ste 101 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Bozeman MT 59715 Phone: 406-586-3351 Fax:406-586-0437 INSURERS AFFORDING COVERAGE NAIC# INSURED wsuRERA St Paul Travelers 25615 INSURER B'. DOWntOWn BOZeman Association Downtown Business Improvement INSURER C. PO BOX 482 Bozeman MT 59771 INSURER D: INSURER E. COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOiN/ITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEM 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE (MMlDD1Y1') DATE (MMIDD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE ~, $ lOOOOOO X COMMERCIAL GENERAL LIABILITY 16609870A017TPHX07 PREMISES (Ea occurence) ~'. $ 100000 CLAIMS MADE ^ OCCUR MED EXP (Any one person) ', $ SOOO A X BUS1neS5 Owners 06/06/07 06/06/08 PERSONAL&ADVINJURY $lOOOOOO GENERAL AGGREGATE li $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMP/OP AGG ' $2000000 POLICY PRO LOC JECT AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ IOOOOOOO A ANY AUTO BA9012W58A075EL 06/06/07 06/06/08 (Ea accident) }{ ALL OWNED AUTOS BODILY INJURY 'I $ }{ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY ~. $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ ~ AUTO ONLY. AGG i $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1 , OOO , OOO A OCCUR ^ CLAIMSFMDE ISFCUP9012W683IND07 06/06/07 06/06/08 AGGREGATE !$ 1,000,000 I$ DEDUCTIBLE ', $ X RETENTION $10000 $ WORKERS COMPENSATION AND ' TORY LIMITS ER EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT ~' $ OFFICER/MEMBER EXCLUDE09 E.L. DISEASE - EA EMPLOYEE' $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT I. $ OTHER PROPERTY 12134 DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS Holder is listed as Additional Insured in respect to the General Liability. CERTIFICATE HOLDER CANCELLATION _ _ _ _ _ _ 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City OP BO Zeman PO Box 1230 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR BOZeman MT 59771 REPRESENTATIVES. AUTHO Ig RESENTATIVE ACORD 25 X2001/08) ~ ' / ©ACORD CORPORATION 1988 From: Alyssa Raser At: Western States Insurance FaxID: Western States Insur To: City of Bozeman Date: 4!72008 04:53 PM Page: 3 of 5 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. 25fT00110R1