HomeMy WebLinkAboutPEPSI BOTTLING GROUP - INSURANCE CERTIFICATE (2)ACORDno CERTIFICATE OF LIABILITY INSURANCE L/v2010 DAT1z 12/z s'
PRODUCER LOCKTON COMPANIES, LLC-N DALLAS THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
717 N. HARWOOD, LB#27 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
DALLAS 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 Pepsi Bottling Group, Inc. INSURERA. Old RepUbllc ]nsurance Company 24147
1065871 One Pepsi Way
Somers NY 10589 INSURER B.
INSURER D.
r nU`rPAr:FS PFPRno 1 FI THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING
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.
INSR
LTR
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/OD/YV)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 2,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
WW"I"Y 58106
1/1/2009
1/I/2010
DAMAGFTORENTED
PREMISES Eaoccurence
$ 100000
MED EXP (Any one person)
$ 1,000
PERSONAL&ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMPIOP AGG
$ 2000000
PRO-
POLICV JECT LOC
A
AUTOMOBILE
LIABILITY
ANY AUTO
MW'I'B 20506
I/l/2009
1/1/2010
COMBINED SINGLE LIMIT
(Ea accident)
$ ],000,000
X
BODILY INJURY
(Per person)
$ XXXXXXX
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Par accident)
$ XXXXXXX
HIRED AUTOS
NON-0WNED AUTOS
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
GAR AGE LIABILITY
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
ANY AUTO
NOTAPPLICAB11
OTHER THAN EA ACC
$ XXXXXXX
AUTO ONLY: AGG
$ XXXXXXX
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$ XXXXXXX
OCCUR CLAIMS MADE
AGGREGATE
$ XXXXXXX
❑ UMBRELLA
NO'f APPLICABLE
$ XXXXXXX
$ XXXXXXX
DEDUCTIBLE FORM
$ XXXXXXX
RETENTION $
A
WORKERS COMPENSATION AND
LIABILITY
ANY PROPRIETOWPARTNEWEXECUTIVE
MWC 115711 no
1/1/2009
I/1/2010
X I TORYSTATO OER
LIMEMPLOYERS'
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
OFFICERIMEMBER EXCLUDED?
SPEC.e NO SPECIALALPROVISIONS WOWE.L.
DISEASE -POLICY LIMIT
$ 1,000,000
OTHER
A
MOTOR CARGO
MWE 22209
I/l/2009
1/1/2010
$100,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
The City of Fort Collins, its officers, agents and employees are named as additional insured with respects to General Liability and Auto Liability for any
claims arising out of work performed under their agreement. fhe Insurance evidenced by this certificate will not be cancelled or materially altered except after
ten (10) days written notice has been received by the City of Fort Collins.
A0.14J00 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
The City 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 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Fort Collins CO 80522-0580
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE i
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