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PEPSI COLA METROPOLITAN BOTTLING COMPANY INC - INSURANCE CERTIFICATE
ACORD,. DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1/1/2011 2/26/2010 PRODUCER LOCKTON COMPANIES, LLC-N DALLAS 717 N. HARWOOD, LB#27 DALLAS TX 75201 214-969-6700 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 Pepsi -Cola Metropolitan Bottling Company, Inc. 1065871 PepsiCo, Inc. One Pepsi Way Somers NY 10589 INSURER A: ACE American Insurance Company 22667 INSURER B : indemnity Insurance Co of North America 43575 INSURER C INSURER D : INSURER E : COVERAGES PEPB00 1 El THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUINC 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 ADD'L POLICY EFFECTIVE POLICY EXPIRATION LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 5,000,000 A X COMMERCIAL GENERAL LIABILITY _ CLAIMS MADE FX1 OCCUR HDO G24940512 2/26/2010 I/1/2011 DAMAGE TO RENTED PREMISES Ea occurence $ 2,000,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ 5,000,000 GENERAL AGGREGATE $ 51000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 5,000,000 PRO - POLICY JECT LOC A AUTOMOBILE LIABILITY ANY AUTO ISA H08588661 2/26/2010 1/1/2011 COMBINED SINGLE LIMIT (Ea accident) $ 5,000,000 X BODILY -INJURY (Per person) $ XXXXXXX ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per accident) $ XXXXXXX HIRED AUTOS NOWOWNED AUTOS .. - .. _. PROPERTY DAMAGE (Per accident) $ XXXXXX X r' GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX ANY AUTO NOT APPLICABLE OTHER THAN EA ACC $ XXXXXXX AUTO ONLY: AGG $ XXXXXXX EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ XXXXXXX OCCUR CLAIMS MADE AGGREGATE $ XXXXXXX ❑ UMBRELLA NOT APPLICABLE $ XXXXXXX $ XXXXXXX DEDUCTIBLE FORM $ XXXXXXX RETENTION $ B A A A WORKERS COMPENSATION AND- _ EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE � OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If ECALPRe PROVISIONS SPECIAL SPECIAL PROVISIONS below -Wi-R C461 ±2622 (A(�S) -.--- :+• _ WLR C46132634 (AZ & CA) SCF C46132646 WI ( ) WCU C4613266A (OH -PC Metro) 2!7_h(2010_ __ 2/26/2010 2/26/2010 2/26/2010 c _'/1/2011, I/l/2011 1/1/201 I 1/l/2011 OTH= R i Ci "Y'S _ — E.L. EACH ACCIDENT $ 5,000,000 E.L. DISEASE - EA EMPLOYEE $ 5,000,000 E.L. DISEASE -POLICY LIMIT $ 5,000,000 OTHER W/C STAT LIMITS A EXCESS WORK COMP WCU C46132671 (WV -PC Metro) 2/26/2010 1/l/2011 $5M EA ACC/EE FOR DISEASE A MOTOR TRUCK CARGO IMC H08588673 2/26/2010 1/l/2011 $100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Policies listed above are effective 02/26/2010 4:01 PM EST. 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. The 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. 2814386 The City of Fort Collins 215 North Mason Street - 2nd Floor PO Box 580 Fort Collins CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 AUTHORIZED REPRESENTA ACORD 25 (2009/011 © 1988-2nn9 ACORN CORPORATION_ All rinhts rPQPrvPd The ACORD name and logo are registered marks of ACORD qu estions uestions reaardina this certificate. contact the number listed in the 'Pro ucer section above and soecifv the client code'PEPBO01'.