HomeMy WebLinkAboutTUMBLEWEED - INSURANCE CERTIFICATE (3)ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID J DATE (MMIDD/YVYY)
TUMBL-1 06 04 OB
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 0 Box 2226 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80522-2226
Phone: 970-482-7747 Fax:970-484-4165 INSURERS AFFORDING COVERAGE NAIC#
INSURER A: Auto -Owners Insurance
INSURER B:
Tumbleweed Super Tasty Treats INSURER C'
David Ammann dba — _
525 Peterson Street INSURER D:
Fort Collins CO 80524-3137-------------
INSURER E:
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.
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER
DATE MMIDDIYY
DATE MMIDDIYY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$500,000
PREMISES Eaoccuren�
_
s300,000_____
A
X
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE aOCCUR
0623327485709007
06/28/07
06/28/08
MED EXP(Any one person)
$10,000
PERSONAL &ADV INJURY
$500,000
GENERAL AGGREGATE
$1,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$1,000,000
X I POLICY PRO—
JECT
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea 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 EAACC
$
ANYAUTO
$
AUTO ONLY: AGO
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
_
$
RETENTION $
WORKERS COMPENSATION AND
TORY LIMITS ER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE
EL EACH ACCIDENT
$
EL.DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED?
R yes, describe under
SPECIAL PROVISIONS be.
E.L. DISEASE -POLICY LIMIT
----- —
$
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Concessionaires.
Certificate Holder is named as Additional Insured as respects the General
Liability and operations of the named insured.
Attn: Christine Jarvis FAX: 970-221-6707
�=n I IrK,A I c n V L.ucn
City of Ft. Collins
Finance Department
Purchasing Division
281 N College Avenue
Fort Collins CO 80522
FTCOLLI I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI
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