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HomeMy WebLinkAboutCONEJO AZUL - INSURANCE CERTIFICATE (2)5/12/2008 2:54 PM FROM: Fax WELSH INSURANCE AGENCY, ➢dC. TO: 221-6107 PAGE: 001 OF 001 a`corr�� CERTIFICATE OF LIABILITY INSURANCE DA05/r12/DBIYY) PRODUCER Welsh Insurance Agency, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 4033 Boardwalk Dive, Suite #200 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fort Collins, CO 80525 _ ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW._ INSURERS AFFORDING COVERAGE NAIC # Phone (970)206-1810 Fax (970)206-1808 INSURED ConejoAzul, Inc. 410 S. Grant Ave' Fort Collins, CO 805212539 INSURER A; AUTO-OWNERSINSURACE CO INSURER 8. INSURER C: INSURER D: INSURER E: COVERAGES INSURER F: THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHfCH THIS CERTIFICATE MAYBE 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 ADD'L INSRD TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE DATE (101,4100M) POLICYEXPIRATION DATE (MMIDDM') LIMITS GENERAL LIABILITY EACH OCCURRENCE 600,000 Q COMMERCIAL GENERAL LIABILITY 74926439 08/28/07 08/25/08 G@YORENTYD— PREMISES Eaoccurence 300,000 A © ❑❑ CLAIMS MADE Q OCCUR ❑ MED EXP(Any one person) 10,000 PERSONAL &ADV INJURY 500,000 GENERAL AGGREGATE 1,000,000 GENT AGGREGATE LIMIT APPLI ES PER: PRODUCTS-COMP/OPAGG 1,000,000 E] POLICY ❑ PROJECT ❑ LOC AUTOMOBILE LIABILITY ❑ ANY AUTO COMBINED SINGLE LIMIT (Ea accident) ❑ ❑ ALL OWNED AUTOS ❑ SCHEDULEDAUTOS ❑ HIREDAUTOS ❑ NON OWNED AUTOS BODILY INJURY (Per person) BODILY INJURY (Per accident) I PROPERTY DAMAGE _ --- (Per accident) ❑ GARAGE LIABILITY ❑ ANYAUTO ❑ _ _ AUTO ONLY EA ACCIDENT --- -- OTHER THAN EA ACC AUTO ONLY AGG — EXCESSIUMBRELLA LIABILITY _ EACH OCCURRENCE ❑ OCCUR ❑ CLAIMS MADE AGGREGATE ❑ ❑ DEDUCTIBLE ❑ RETENTION $ ----- WORKERSCOMPENSATIONAND EMPLOYERS'LIABILITY ❑TORY LIMITS L-' ERH E.L. EACH ACCI DENT _ ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER R EXCLUDED? If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE EA EMPLOYEE E.L. DISEASE- POLICY LIMIT OTHER —....._... DESCRIPTION OF OPERATIONS 1 LOCATIONS 1 VEHICLES! EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS HOT DOG STAND CITY OF FORT COLLLINS IS LISTED AS ADDITIONAL INSURED. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL City of Fort Collins - PURCHASING DEPARTMENT 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO Attn: Purchasing PO Box 580 THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. __ .._.._ ____ AUTHORIZED REPRESENTATIVE �,,,(,�,{ 221-6707 AGOHU 2a (ZUUIIUS) OF © ACORD CORPORATION 1988