HomeMy WebLinkAboutPEPSI BOTTLING GROUP - INSURANCE CERTIFICATEACORD,N CERTIFICATE OF LIABILITY INSURANCE
DAT12/17/2007Y)
l/l/2009
PRODUCER LOCKT ON COMPANIES, LLC-N DALLAS
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
717 N HARWOOD, LBh27
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
DALLAS TX 75201
HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
214-969-6700
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE
NAIC#
INSURED
INSURER A OLD REPUBLIC INSURANCE CO
1065871 PepOnesPESPSIIngayGyroup, In c.INSURER
B
Somers NY 10589
INSURER C
INSURER D
NSURER E
I
COVERAGES PEPBOOI ElTHIS NSURERISLIAUTHORIOF ZED REPRESENTATIVE OR PRODUCER AND THE CERTIT CONSTITUTE A CONTRACT FICATE HOLEN THE DER
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 `NHICH 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
TR
ADD L
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
IYY)
POLICY EXPIRATION
DATE(MMIODIYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$2 000,(100
A
—
X DDMMIEPCiAL GENERAL LIAR'JTV
MWZY S76�5
1/1/��Q$
I/I rJDOt�
DAMA>( E TO RENTED
PREMISES Ea ocrurence
$., UO,000--
CLAIMSMADE OO(CUR
MEDEXP(Any on.parsoN
$1,000
PERSONAL & ADV INJURY
$1,000,000
GENERAL AGGREGATE
$2,000,000
GEN L AGGREGATE LIMIT APPLIES PER
PRODUCTS COMP/OP ASS
$2,000 000
POLICY PFCOT =LOC
A
AUTOMOBILE
LIABIUTY
ANYAUTO
IVIWTB 19965
I/l/2008
I/l/2009
COMBINED SINGLE LIMIT
En account)
61,000,000
X
BODILY INJURY
(Per person)
$XXXXXXXXXX
ALL ONNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per accloent)
$XXXXXXXXXX
HIRED AUTOS
NON OWNED AUTOS
PROPERTY DAMAGE
IPer accident)
$XXXXXXXXXX
GARAGE LIABILITY
AUTO ONLY EA ACCIDENT
$XXXXXXXXXX
OTHER THAN EA ACC
$XXXXXXXXXX
ANYAUTO
NOT APPLICABLE
$XXXXXXXXXX
AUTO ONLY AGG
EXCESSIUNI BRELLA LIABILITY
EACH OCCURRENCE
$XXXXXXXXXX
OCCUR �CLAIMSMADE
NOT APPLICABLE
AGGREGATE
$XXXXXXXXXX
$XXXXXXXXXX
❑ UMBREI LA
$XXXXXXXXXX
DEDUCTIBLE FORM
$XXXXXXXXXX
RETENTION $
A
WORKERS COMPINSATION AND
EMPLOYERS LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
W
MC 1]534100
I/l/20nX_-
1/I/2000
�X W CSTATU OTH
_
E L EACH ACCIDENT
$1,000,000
E L DISEASE EA EMPLOYEE
$1,000,000
OFFICER/MEMBER EXCLUDED'
If yes describe under
SPECIAL PROVISIONS below NO
E L DISEASE POLICY LIMIT
$1,000,000
OTHER
A
MOTORCARGO
MWE22197
I/l/2008
1/1/2009
$100000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Fan Collins, its officers, agents and clnployLLS are named as additional insured with respuTs to General Liability and Auto Liability for any claims
ansing out of work performed under their agreement The Insurance evidenced by this certificate w Ill not be cancelled or materially altered except after ten (10) days
written nonce has been received by the Cityof Fan Collins
2814386 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
The Cib/ of Fort Collins DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
215 North Mason Street - 2nd Floor NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL
PO Box 580
Fort Collins CO 80522-0 580 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR
REPRESENTATIVES
AUTHORIZED REPRESENTATIVE p,
ACORD 2512001POR1 For R...n...r.P.nIngtm.s.nm-an...ma-a-e-mlieldi.emm.Prod...r..aimabo..and speedy the al..% tea. PEPeoI0 Ar:DRD CDRPDRATIDN I9RR