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A`°R°® CERTIFICATE OF LIABILITY INSURANCE ) <br /> 4/9/2014 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT D.Darb <br /> NAME: y <br /> RiskPlan Insurance PHONE (303)684-0888 FAX (303)684-0887 <br /> (A/C.No.Extl: (A/C,No): <br /> 659 4th Avenue ADORIess:diana @riskplaninsurance.com <br /> INSURER(S)AFFORDING COVERAGE NAIC it <br /> Longmont CO 80501 INSURER A:Continental Western Insurance 10804 <br /> INSURED <br /> INSURER B: <br /> Boulder and Left Hand Irrigation Company INSURERC: <br /> PO Box 1826 INSURERD: <br /> INSURER E: <br /> Longmont CO 80502 INSURERF: <br /> COVERAGES CERTIFICATE NUMBER:CL084100134 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS <br /> LTR INSR WVD POLICY NUMBER -(MM/DD/YYYY) (MM/DD/YYYY) <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY PR TO RENTED PREMISES l(Ea occurrence) $ 100,000 <br /> A CLAIMS-MADE X OCCUR X PEP3015853-32 3/28/2014 3/28/2015 MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADVINJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> POLICY PRO- LOC $ - <br /> 1FC:T <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) $ _ <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> A ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS (Per accident) <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE _ $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y/N TORY LIMITS FR <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? NIA <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) <br /> Dam, Levee or Reservoir Operations class code 39002 O <br /> 4Q <br /> Certificate holder is listed as Additional Insured per CG2026(07/04) with respects Gen per <br /> terms and conditions of policy. OVa <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Colorado Water Conservation Board ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 1580 Logan St. , Suite 600 <br /> Denver, CO 80203 AUTHORIZED REPRESENTATIVE <br /> — <br /> Diana Darby/DIANA <br /> ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025(701005101 The Af`f1Rrl name anr1 Irwin arc rcnicfcrcrl marks of Arnizm <br />