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HomeMy WebLinkAboutCONEJO AZUL INC - INSURANCE CERTIFICATE3/24/2009 12:21 PM FROM: Fax ttelsh Insurance TO: 221-6707 PAGE: 001 OF 001 ACOr_—ROte CERTIFICATE OF LIABILITY INSURANCE DATE 03(24/09 YY) PRODUCER Welsh Insurance Agency, Inc. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 4033 Boardwalk Drive, Suite #200 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fort Collins, CO 80525 ALTER THE COVERAGE AFFORDED BY THE POLICIES, BELOW. Phone (970)206-1810 Fax (970)206-1808 INSURERS AFFORDING COVERAGE NAIC # INSURED Conejo Azul, Inc. INSURER A: AUTO -OWNERS INSURANCE CO INSURER 8: 410 S. Grant Ave. INSURER C Fort Collins, CO 805212539 INSURER D: _ E: COVERAGES INSURER 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 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. ILR TR AD INSM RD TYPE OF INSURANCE POLICY NUMBER FDATEYMMIODM'j DATE (MMNDM') N LIMITS GENERAL LIABILITY EACH OCCURRENCE 500,000 �� COMMERCIAL GENERAL LIABILITY 74926439 08/28/08 08/25/09 17AMAGETO-R ccure PREMISES Ee occurence 300,000 A Q ❑❑ CLAIMSMADE LV OCCUR ❑ MED EXP (Any one person) 10,000 PERSONAL &ADV INJURY 500,000 ❑ GENERAL AGGREGATE 1,000,000 GEHL AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG 1,000,000 0 POLICY ❑ PROJECT ❑ LOG AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT ❑ ANYAUTO (Ea accident) BODILY INJURY (Per person) ❑ ❑ ALL OWNED AUTOS ❑ SCHEDULEDAUTOS ❑ HIREDAUTOS ❑ NON OWNED AUTOS BODILY INJURY (Per accident) ❑ ( PROPERTY DAMAGE (Per accident) GARAGE LIABILITY _ AUTO ONLY - EA ACCIDENT OTHERTHAN _EA ACC ❑ ❑ ANYAUTO ❑ AUTO ONLY: AGG EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE AGGREGATE ❑ OCCUR ❑ CLAIMS MADE ❑ DEDUCTIBLE ❑ RETENTION $ WORKERS COMPENSATION AND ❑ WC STATU- ❑ OTH- EMPLOYERS'LIABILITY TORY LIMITS ER E.L. EACH ACCIDENT ANY PROPRIETOR / PARTNER / EXECUTIVE OFFICER /MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE Il'yes, describe under SPECIAL PROVISIONS below E.L.DISEASE POLICY LIMIT OTHER DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / 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 Department THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. PO Box 580 AUTHORIZED REPRESENTATIVE FORT COLLINS, CO 80524 221-6707 ACORD 25 (2001/08) QF ©ACORD CORPORATION 1988