HomeMy WebLinkAboutKansas City Kitty LLC - Insurance Certificate .raco CERTIFICATE OF LIABILITY INSURANCE D 05/03/20 5YY)
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(8),
AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed, If$1,151100ATIONI8 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 -
NUTMEG INS AGENCY INC/PHS FAz
76210781 PHONE (888)925-3137
The Hartford Business Service Center (ac,No,Ext): (A/C.No):
3600 Wiseman Blvd E-MAIL
San Antonio,TX 78251 ADDRESS:
INSURERS)AFFORDING COVERAGE NAICN
INSURFO INSURER A: Hartford Underwriters Insurance Company_ 30104
KANSAS CITY KITTY LLC INSURER B:
136 N COLLEGE AVE INSURER C
FORT COLLINS CO 80524-2451
INSURER D
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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,
INS TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $1,000,000 I:
CLAIMS-MADE1XIOCCUR DAMAGE TORENTE $1,000.000
X General Liability MED EXP(Any one person) $10,000
A 76SBWBG5DET 06/01/2026 06/01/2026 PERSONAL aADVINJURY— $1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000
X POLICY❑PRO- ❑LOC PRODUCTS•COMP/OP AGO $2,000,000
JECT
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
ANY AUTO BODILY INJURY(Per person)
ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Par accident)
HIRED NON-OWNED P110130TV-Dw9var
AUTOS AUTOS (Per accident)
UMBRELLA LIAB OCCUR EACH OCCURRENCE
EXCE88 LIAR CLAIMS-MADE AGGREGATE
ED RETENTION$
WORKERS COMPENSATION P OTH-
AND EMPLOYERS'LIABILITY
ANY YIN E.L.EACH ACCIDENT
PROPRIETOPJPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED? NIA E.L.DISEASE-EA EMPLOYEE
(Mandatory in NH)
If yes.describe under E.L.DISEASE-POLICY LIMIT
DESCRIPTION OF OPERATIONS w
A Employment Practices Liability Each Claim Limit $26,000
76,( OB/01/2028 BG5DET OB/01/2026
Insurance I Annual Aggregate Limit $25,000
DESCRIPTION OF OPERA77ONS i LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required)
Those usual to the Insured's Operations,
CERTIFICATE HOLDER CAMELLATIQN
CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
ATTN:ENGINEERING DEPT BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED
281 N COLLEGE AVE IN ACCORDANCE WITH THE POLICY PROVISIONS.
FORT COLLINS CO 80524 AUTHORIZED REPRESENTATIVE
01988.2015 ACORD CORPORATION.All rights reserved.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD
CERTIFICATE OF LIABILITY INSURANCE D 05/03/20 sue)
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,
THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),
AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed, If SUBROGATIONI8 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 Ilsu of such endorsement(s).
PRODUCER CONTACT - - --— - - N
NORTHEAST AGENCIES INC/PHSME
01214608 PHONE (866)467-8730 - __-
FAX
The Hartford Business Service Center (ac,No,Ext): IA/C.No): g
3600 Wiseman Blvd E-MAIL
San Antonio,TX 78251 ADDRESS:
INSURER(B)AFFORDING COVERAGE NAICM
INSURED INSURER A: Twin City Fire Insurance Company 29459
KANSAS CITY KITTY LLC INSURER 8:
136 N COLLEGE AVE
FORT COLLINS CO 80524-2451 INSURER C:
INSURER D:
INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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.
INS TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
CLAIMS-MADE❑OCCUR DAMAGE TO RENTED i:!I
_ I
MED EXP(Any one person) j Iq.
PERSONAL tt,ADV INJURY h1,j
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE
POLICY❑PRO- ❑LOC PRODUCTS-COMPIOP AGG
JECT
OTHER:
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Q accident)
ANY AUTO BODILY INJURY(Par person)
ALL OWNED SCHEDULED - -
AUTOS AUTOS BODILY INJURY(Per accident)
HIRED NON-OWNED
R -- -
AUTOS AUTOS (Per accident)
FOCCUR - -
UMBRELIA LIAR EACH OCCURRENCE
EXCESS LIAB CLAIMS- -
MADE AGGREGATE
DED RETENTION$
WORKERS COMPENSATION X PER OT -
AND EMPLOYERS'LIABILITY
ANY YIN E.L.EACH ACCIDENT $500,000
A PROPRIETORIPARTNEPJEXECUTIVE NIA 01 WEC VK6663 02/10/2025 02/10/2026
OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,000
(Mandatory in NH)
If yes,describe under E.L.DISEASE-POLICY LIMIT $500,000
DESCRIPTION OPERATIONS
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required)
Those usual to the Insured's Operations,
CERTIFICATE HOLDER GANOLLATI N
CITY OF FORT COLLINS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 09 CANCELLED
ATTN:ENGINEERING DEPT BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED
281 N COLLEGE AVE IN ACCORDANCE WITH THE POLICY PROVISIONS.
FORT COLLINS CO 80524 AUTHORIZED REPRESENTATIVE
01988.2015 ACORD CORPORATION.All rights rose ad.
ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD