HomeMy WebLinkAbout124299 TOAST OF THE TOWN - INSURANCE CERTIFICATEACORDM CERTIFICATE OF LIABILITY INSURANCE
7DATE (MM/DDlYYYY)
23/2009
PRODUCER (970) 484-2805
John C. Beckett & Associates, Inc.
220 Smith Street
Ft. Collins CO 80524 -
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
Toast Of The Town, Inc.
523 N. Whitcomb
Fort Collins CO 80521-
INSURERA: PENN-AMERICA INS. CO.
INSURER B FOUNDERS INSURANCE CO.
INSURER
INSURER D.
1 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.
INSR
LTR
ADDI
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DDIYY)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
A
GENERAL LIABILITY
/ /
/ /
EACH OCCURRENCE
S 5001000
DAMAGE TO RENTED
PREMISES Ea occurrence)
$ 100,000
h COMMERCIAL GENERAL LIABILITY
MEDEXP An one person)
S 5,000
CLAIMS MADE � OCCUR
PAC6794939
02/11/2009
02/11/2010
PERSONAL&ADVINJURY
$ 500,000
GENERAL AGGREGATE
$ 500,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 500,000
X1 POLICY F7 ECOT F7 LOC
AUTOMOBILE
LIABILITY
NO COVERAGE
/ /
/ /
COMBINED SINGLE LIMIT
(Ea accident)
$
ANY AUTO
BODILY INJURY
(Per person)
S
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 EA ACC
$
ANY AUTO
NO COVERAGE
/ /
/ /
$
AUTO ONLY: AGG
EXCESSIUMBRELLA LIABILITY
NO COVERAGE
/ /
/ /
EACH OCCURRENCE
$
AGGREGATE
$
OCCUR CLAIMS MADE
S
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION AND
NO COVERAGE
/ /
/ /
ORY LIMITS OER
EMPLOYERS' LIABILITY
AN V PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMtsER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
S
B
OTHER LIQUOR LIABILITY
LLC0000608
02/11/2009
02/11/2010
OCCURRENCE 500,000
AGGREGATE 500,000
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Ia:Colltoj;m
(970) 224-6134
Purchase & Risk Managment
City of Fort Collins
P.O. BOX 580
Fort Collins CO 80522-
UA NUCLLH 1 IUN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION 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 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE .._......
.., ..........._�
ACORD 25 (2001/08) v At,Urcu t UKrUrw I IUry I VOO
i
M INS025 (0108).05 ELECTRONIC LASER FORMS, INC. - (800)327-0545 Page 1 of 2