HomeMy WebLinkAboutTUMBLEWEED - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID J
DATE(MMIDD/YYYY)
TIIOPID
06 21 07
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
125 S Howes, 5th Floor
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P O Box 2226
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80522-2226
Phonet970-482-7747 Faxt970-484-4165
INSURERS AFFORDING COVERAGE
NAICS
INSURED
INSURER A: Auto -Owners Insurance
INSURER B.
Tumleweed Super Tasty Treats
David AmmaJa9nn dba
INSURER C:
NSURERD:
FortPCollins COr80524-3137
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 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.
Imart
LTR
NS
TYPE OF INSURANCE
POLICY NUMBER
POLICYEFFECTIVE
DATE MMID
MMID
DATE MMN
LIMITS
GENERAL LIABIL(T1'
EACH OCCURRENCE
$ 5 O 0, 0 0 0
A
$
$ COMMERCIAL GENERAL LIABILITY
0623327485709007
06/28/07
06/28/08
PREMISES Esoccurence
s 300, 000
CLAIMS MADE ® OCCUR
MED EXP (Any are person)
$ 10 , 00 0
PERSONAL S ADV INJURY
$500,000
GENERAL AGGREGATE
$1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGG
$ 1 , 000 , 0 00
$ POLICY jE LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Es accident)
$
BODILY INJURY
(Per person)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accident)
$
HIRED AUTOS
NON -OWNED AUTOS
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
S
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
- -
TORY LIMITS I I ER
E.L. EACH ACCIDENT
$
ANY PROPRIETORPARTNER. SXECUTWE
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED?
H yea, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT 1
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Concessionaires.
Certificate Holder is named as Additional Insured as respects the General
Liability and operations of the named insured.
Attn: Christine Jarvis or David Carey FA$t 970-221-6707
v c.� n . c r.vcvcr� a..vwccu+nvn
FTCOLLI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Ft. Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
Finance Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Division IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
281 N College Avenue
Fort Collins CO 80522 REPRESENTATIVES.
25 (20011081