HomeMy WebLinkAboutMAXWELL HUGHES SUGAR RAYS - INSURANCE CERTIFICATEOct-20-08 03:15pm From-Brown&Brown
9704844165
ACORD CERTIFICATE OF LIABILITY INSURANCE
3rown & Brown Inc
L25 S Howes, Sth Floor
? O Sox 2226
?ort Collins CO $0522-2226
Phone: 970-482-7747 Fax:970-484-4165
Sugar Rayys
Maxwell Hughes dba
617 Mathews St.
Fort Collins CO 80524
T-406 P.001/001 F-754
nnm "I DAYEIMMIDDIYYYY)
HOLDER, THIS CERTIFICATE: DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE WIC #
INSURERA: Allied Group,_
INSURER B: IF�
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCVMENT WITH RESPECT TO WHICH TIIIS 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.
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iNSRE
TYPEOFINSURANCE
POLICY NUMBER
CTn
OATS MMIDO
P�CPEXP1ifATIbN
DATE MbVbDNY
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
S50)000
A
X
X GDMI/ERCIAL CENER4L LIAOILIN
ACP7503713731
10/21/08
10/21/09
PREMISES(Ea ocdwenoo)
3107000
CLAIMS MADE O OCCUR
MED EXP (" Pn. percn)
S 1000
PERSONAL&ADV INJURY
S 50 D000
GENERALAGGREGATE
$1000000
GEN'L AGGREGATE LIMIT APPLIES PER.
PRODUCTS -COMPIOP AGG
SIG 00000
POLICY PROS
JECT LOC
-�
AUTOMOBILE
LIABILRY
ANYAUTO
COMBINED SINGLE LIMB
(Eae v-,,S
S
BODILY INJURY
(Per Person)
ALL OWNED AUTOS
SCHEDVLEDAUTOS
S
BODILY INJURY
IPW ewd.m)
HIRED AUTOS
NON -OWNED AUTOS
S
PROPERTY DAMAGE
(PereCGdOnI)
S
..
GARAGELIABILITY
AUTO ONLY -RA ACCIDENT
Z
OTHERTHAN EAACC
_
S _
^� ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
5
AGGREGATE
__
5
_
S
DEDUCTIBLE
RETENTION S
S
WORKERS COMPENSATION AND
TORT LIMIT& EH
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE
- - '
$
- -
E.L. EACH ACCIDENT
EL DISEASE•EAEMPLOYEE
OFFICERIMEMBER EXCLUDED?
S
If Yee, dsI;wW lmd.,
SPECIAL PROVISIONS oelow
.•.
EL. DISEASE • POLICY LIMIT
—•-•
S
OTHER
DESCRIPTION OF OPERATIONS I LLICATIONS f VEHICLES I EXCLUSIONS ADDED EY ENDORSEMENT/ SPECIAL PROVISIONS
Certificate Holder is named as Additional Insured as respects the General
Liability and operations of the named insured.
Attn: David M. Carey Fax 970-221-6707
city of Fort Collins
PO Sox 580
Fort Collins CO 80521
25
CITXFIO I SHOULD ANY OF THEAEOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIMATE HOLDER NAMED TO THE LEFT, BUT FAILUF:_ TO DO E0 SHALL
IMPOSE NO OBLIGATION OR LIABILTY OF ANY RIND UPON THE INSURER. TB AGENTS OR