HomeMy WebLinkAbout158752 WILCOX INC DBA BOTTOMS UP - INSURANCE CERTIFICATE08/01/2008 11:30 19702040305 STANSFIELD INSURANCE PAGE 01
The Stansfield Insurance Agency
5125 S College Ave, Ste B
Fort Collins, CO 80525
970 / 204 - 0020
INSURED
DBA: Bottoms Up Bar Service
Kevin Wilcox
1200 Raintree Dr
Ft Collins,CO 80521
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COMPANY
A Scott
COMPANY
B
COMPANY
C
COMPANY
DATE (MANDD/YV)
!'il 08/01/08
AS A MATTER OF INFORMATION
TIGHTS UPON THE CERTIFICATE
DOES NOT AMEND, EXTEND OR
IRDED BY THE POLICIES BELOW.
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INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CON "I PACT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
1 ITR
TYPE OF INSURANCE
POLICYNUMBER
POUCVEFFECTIVE
POLICY EXPIRATION
W LIMITS
`GENERAL
DATE(MWDDNY)
DATE(MM/OOIYY)
LIASfUTY
®�
BODILY IN -JURY GOO
$_500,000
X COMPREHENSIVE FORM
BODILY INJURY AGO
$1, 000, 00_0_
X PREMISESIOPERATIONS
_
PROPERTY DAMAGE OCC
$500, 000 m
UNDERGROUND
EXPLOSION 8 COLLAPSE HAZARD
--
PROPERTY DAMAGE AGO
$1, 000, 000 W
A
X PRODUCTSICOMPLETEDOPER
81 & ED COMBINED OCC
s500,000
CONTRACTUAL
CLS1512964
06/21/08
06/21/09
BI&PD COMBINED AGE
$1,000,000
I NDEPF.NDENT CONTRACTORS
_
PERSONAL INJURY ADDT
S1,000,000
X BROAD FORM PROPERTY DAMAGE
Liq Liab
500,000
ad Ex
X PERSONAL INJURY
AUTOMOBILE LIABILITY
T
BODILY INJURY
$
ANY AUTO
(Per person)
ALL OWNED AUTOS (Private Pass)
-----
ALL
Otheerr
dODILYINJURY
$
than Private Passenger)
(Per aalnenl)
HIRED AUTOS
NON "OWNED AUTOS
PROPERTY DAMAGE
$
GARAGE LIABILITY
BODILY INJURY&
PROPERTY DAMAGE
$
-.
.---...„.,...®..._......___.._._��......,.
��._....._._......___.....f_,.._.—.......,..>...�_.�....,.��.,�.-,.
EXCESS LIABILITY
.....,COMBINED
EACH OCCURRENCE
... .. .�
UMBRELLAFORM
AGGREGATE
$ _ I�
_.._.................�,--..............
OTIIER THAN UMBRELLA FORM
...�
_... _._.-._..-,,._.e...�,.e,..H.. �...._r,,,,m._.v.._...._..
_...
$ f
p
WORKERS COMPENSATION AND
- - m
OTI I-
MINES
- h�
EMPLOYERS' LIABILTY
'f LIM TS ER
15r
EL EACH ACCIDENT
„— _,_
$
S
THE PROPRE XECUTORI INCL
ERSIEXECUTIVE
EL DISEASE -POLICY LIMIT
OFFICERS
OFFICERS ARE: EXCL
_
EL DISEASE -EA EMPLOI EE
$
OTHER
I
Alcohol Catering -Additional, Insured: City of Ft Collins j
�€Ct;'.{C7EyH„ 2� }Sb`jalazk t'UrS kiVkil..i&'`A+;�S—'{,+Slmt, iI.N,E 1r/iTl
City of Fort Collins
Attn: Michelle Reynolds
Fax#: 970-221-6707
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED JeHORB THE
EXPIRATION DATE 'THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ,
_310 DAYS IVBITI'EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LErT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANy OWHE JWpypANY, ITS AGENTS OR REPRESENTATIVES.