HomeMy WebLinkAboutMOUNTAIN DOG INC COZZOLAS PIZZA - INSURANCE CERTIFICATEA ORD„, CERTIFICATE OF LIABILITY INSURANCE
0/200 DATE IYVYY)
1 v1 onoos
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
FLOOD & PETERSON INSURANCE INC
4821 WHEATON DRRIVE
FORT COLLINS, CO 80525
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(888) 661-3938
XY290 882
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
MOUNTAIN DOG, INC.
DBA COZZOLA'S PIZZA
INSURER A:THE TRAVELERS INDEMNITY COMPANY
INSURER B: THE PHOENIX INSURANCE COMPANY
INSURER C:
1112 OAKRIDGE
INSURER D:
FORT COLLINS, CO 80525
INSURER E:
rnvcoer_CQ
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
LTR
ADDl
INSRC
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMM/DD/YY)
POLICY EXPIRATION
DATE (MM/DDIVY)
LIMITS
B
X
GENERAL LIABIITY
680-386N5377-07
01 /06/2007
01 /06/2008
EACH OCCURRENCE
$1 000 000
DAMAGE TO RENTED
PREMISES IF, occurrence)
$ 300,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ❑X OCCUR
MED EXP (Any one ersonl
$ 5 000
PERSONAL & ADV INJURY
$1,000,000
X HIRED AUTO
X
NON OWNED AUTO
GENERAL AGGREGATE
S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$ 2,000,000
PRO-
X POLICY JECTLI LOC
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
IEa accident)
$
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
(Per person)
$
SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY
(Per accident)
$
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
A
EXCESS/UMBRELLA LIABILITY
CUP-386N5377-07
01 /06/2007
01 /06/2008
EACH OCCURRENCE
$1,000,000
AGGREGATE
$ 1,000,000
X1 OCCUR 7 CLAIMS MADE
$
$
DEDUCTIBLE
$
X RETENTION $ 10,000
WORKERS COMPENSATION AND
WC
TORY LIMITS ER
E.L. EACH ACCIDENT
$
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED?
If yes. describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
CITY OF FORT COLLINS
PO BOX 580
FORT COLLINS, CO 85022
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORn 95 120111110111
AUTHORIZED REPRESENTATIVE
CORPORATION 1981