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■ee1 SANTA-1 OP ID:DCB <br /> At�R° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYYI <br /> 03!0412013. <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(les)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 Phone:303-444-4666 Lauren Hix <br /> Insurance Assoc Inc Boulder -PHONE <br /> 3005 Center Green Dr.Ste 120 Fax 303-444-8481 (aq No E.):303-444.4666 TAX Noy 303-444-8481 <br /> Boulder,co 80301 E 'L leh insurance-associates.com <br /> Charles His ADDRESS: _... <br /> INSURER(S)AFFORDING COVERAGE NAICA <br /> INSURER A:American Alternative Insurance <br /> INSURED Santa Maria Reservoir Company INSURER B: <br /> Connie Pleasant <br /> P.O.Box 288 INSURER C: <br /> Monte Vista,CO 81144-0288 INSURER D: .. <br /> INSURERE: ._ — <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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' - - SOBR - - POLICY EFF POLICY EXP LIMITS <br /> LTR TYPE OFINSURANCE INSR woo POLICY NUMBER (MM(DDIYYYYI IMM'DDIYYYYl <br /> GENERALUABIUTY EACH OCCURRENCE S 1,000,000 <br /> A X COMMERCIAL GENERAL LMBN DAMAGE TU RENTED TV ' X GPPA-PF-6050243-03 03!15!2013 j 03!1512014 I PREMISES(Ea occurrence) $ 1,000,000 <br /> CLAIMS-MADE [X:OCCUR MED EXP(Any one person) 5 10,000 <br /> PERSONAL&ADV INJURY S 1,000,000 <br /> 3,000,000 <br /> GENERAL AGGREGATE 5 3,00_ <br /> GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG_ S 3,000,000 <br /> 7 POLICY n rRa [1 LOC ,Emp Ben. s Included <br /> AUTOMOBILE UABIUTY i COMBINED SINGLE LIMIT <br /> i EI(a acG4en0 S .-- <br /> i ANY AUTO -BODILY INJURY(Per person) S <br /> ALL OWNED .SCHEDULED BODILY INJURY(Per our derd) S <br /> AUTOS NON-OWNED PROPERTY DAMAGE S <br /> HIRED AUTOS AUTOS .(PeracddenII <br /> —_ s. <br /> UMBRELLA LIAR i OCCUR I EACH OCCURRENCE S <br /> EXCESS LIAB ,CLAIMS-MADE AGGREGATE S _- <br /> DED I RETENTION S I _ S <br /> WORKERS COMPENSATION ITORY ATU- ,-,..JO R ... <br /> AND EMPLOYERS LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E EACH ACCIDENT _ $ <br /> OFFICERMEMBER EXCLUDED, I N I A <br /> (Mandatory in NH) 1 E.L.DISEASE-EA EMPLOYEE <br /> If yes.describe user <br /> DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY OMIT S <br /> • <br /> • <br /> I <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule.if more apace is required) <br /> The Certificate Holder is hereby named as an Additional Insured, but only in <br /> respects to the General Liability portion of this certificate and limited to <br /> the operations of the Named Insured. <br /> CERTIFICATE HOLDER CANCELLATION <br /> COLOWAT <br /> SHOULD.ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Colorado Water Conservation THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Board <br /> 1580 Logan St AUTHORIZED REPRESENTATIVE <br /> Denver,CO 80203 <br /> g'‘ `-- -4±5- <br /> 1 <br /> ®1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD <br />