HomeMy WebLinkAboutMOUNTAIN DOG COZZOLAS PIZZA - INSURANCE CERTIFICATEMOW.CERTIFICATE OF LIABILITY INSURANCE
UATE0/200NYYYI
11110/2006
PRODUCER
FLOOD & PETERSON INSURANCE INC
FLOOD
WHEATER ON INS
FORT WHEACOLLINS, CO IRIVE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
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.
INSURER A:THE TRAVELERS INDEMNITY COMPANY
DBA COZZOLA'S PIZZA
INSURER B: THE PHOENIX INSURANCE COMPANY
INSURER C:
1112 OAKRIDGE
INSURER D:
FORT COLLINS, CO 80525
INSURER E:
COVERAGES
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 QR 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
ADD'I
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE IMM/DD/YYI
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
B
X
GENERAL LIABIITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [X]OCCUR
X HIRED AUTO
680-386N5377-07
01 /06/2007
01 /06/2008
EACH OCCURRENCE
$ 1 000 000
DAMAGE TOPREMISES RENTED
mel
0
$ ,000
MED EXP An one rson
$55, 000
PERSONAL & ADV INJURY
$ 1,000,000
X
NON OWNED AUTO
GENERAL
$ 2 000 000
GENT AGGREGATE LIMIT APPLIES PER:
PRO-
X POLICY Ll J CTFI LOC
PRODUCTS - COMP OP AGG
$ 2,000,000
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
COMBINED SINGLE LIMIT
(Ea accident)
$
BODILY INJURY
(Per Person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: AGG
$
$
EXCESSIUMBRELLA LIABILITY
X OCCUR CLAIMS MADE
DEDUCTIBLE
X RETENTION $ 10,000
CUP-386N5377-07
01/06/2007
01/06/2008
EACH OCCURRENCE
$1,000,000
AGGREGATE
$ 1,000,000
6
$
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
TWOCRYSTLIAMTITUi ER'
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
E.L. DISEASE - POLICY LIMIT
b
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I 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
ACORD 2S 1200T/ORl
AUTHORIZED REPRESENTATIVE
CORPORATION 19R1