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HomeMy WebLinkAbout114170 COCA-COLA BOTTLING CO GREELEY - INSURANCE CERTIFICATE (4)CCE Atlanta 7/13/2010 3:38:55'PM PAGE 3/006 Fax Server ACORU DATE (MINUMfMY) C_.E,R_T,1­F__I,C.A.,T,E.,. OF LIABILITY INSURANCE . . ........ - ------- - ............. ...... ......... . . ........ ..... . ------ -- .. . ....... ------ ---------- --------- - OUJ1812010 :PRODUCER Marsh USA, Inc. - . ...... . .. .. .. . ......... THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION Two Alliance Center 3515U Lenox ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT Road. Suite 24GO Atlanta, GA 30326 AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, Attp: Adanta.CertRequest@mlrsh.com Fax: 212-940-4321 w 504477--MAST-09-10 INSURERS AFFORDING COVERAGE NAIC Iy *Coca-Cola Enterprises Inc. INSURER AI ACE American Insurance Company 22567 DBA Coca-Cola Bottling Company of Greeley 1200 71h Avenue .......................................... . ­­­­ ......... ...... . .............. . INSURER 13: Indemnity Ins Co Of North America :43575 Greeley, Co 810631-4112 . ..... ........ _­­. I INSURER C: National Union Fire Ins CO ?ittshurgh PA .19445 INS UP E RD; INSURER E, COVERAGES---- -------- ---- - ----------- ............ . ..... ... ..... ... . ­11.1 .... ........ ... .... ............... .. .. . ........ ­ .. ............... ................ ... ............ _1_1 ----------- -- --- ------------ ....... ...... .................. ........... THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO NOTWITHSTANDING THE INSURED . .... N­A'M'E'D -ABOVE FOR THE P(* XlCy PERIOD INDICATED' ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 7 a VVHtCH This CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES !DESCRIBED HEREIN IS SUBJECT 70 ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUM BE R -- - --------- -------------- .LTR,INSRCi 7NERALLIABILITY DATE [MWDDNYYYj DATE IMXDDfYYYY) i LIMITS DO G24935449 a COMMERCIALGENERALLIABILRY 11/01/2009 11/0112010,_EACH OCCURRENCE �_01,30 K�; PREMISES( Be o=re $ n ...... CLAIMS MADE OCCUR q w MED FXP (Any one paon) !S '000 ------------ - ­­1 ------------ . ... .............. PERSONAL &AUV INJURY js 1.000,OOD: GI!NERALAGCRWATE LIMIT APPLIES PER' - -- -------- ---------- ----- GIENERALAGGREGATE 1$ 26,000,000 �X POLICY ! j� LOG ! T PRODUCTS .. ........ .6M rq $ AUTOMOBILE A LIABILITY !ISA H08581964 11/01f2009 1:1110112010 ANYAUTQ COMBINED SINGILL UMIT i(Ea audentl 5,000,000- ALL OWNED AUTOS SCHEDULED 4LPI­CS ...... .. ..... ..... BMILY INJURY a (Per parson) HIRED ALITC3 NON-OWNEDAUTOS BODILY INJURY w (Per Quadent) PROPERTY DAMAGE dent) (Ptf acli is GARAGE LIABILITY AUTCONLY - EAACCIDZNT ANY AUTO OTHER THAN EA ACC . . ................... AUTO ONLY' EXCESS I UM13 RrLLA LIABILITY !BE 27471530 lV0112009 1 11101/2010 EACHOCCURRENCEAGG 5,0c)0,000: X OCCUR "[PAS MADE:: AGGREGATE is DEDUCTIBLE RETENTION S 25.000 ...... ................. . ........ ... $ . ... . ........ q B WORKERS COMPENSALnON AND :WLR C45705055 (AOS) EMPLOYFIRS'LIABILITY 10112009 lV011112010 X I VA, 5TATU- � i 0 TH- iSCF C45705067 (VV[) :A ANY PROPRIETORIPARTNERIEXECUTIVE Y)f N 11/0112009 11,10112010 ---- :TORY LMT3.____1_Efl_j t:.L. EACH ACCIDENT .T___­­ ­­,T.,&d_dI5iT6. OFFICERIMEMSER EXCLUDED? r-- L.L. ixspAsE -EA EMPLOYE 1,000,000. . --------- ­ SPECIAl- PROVISIONS belm E-L. DISEASE. POLICY LIMIT; 11,000,000, Statutory Excess 31MM each A Specific Excess Workers Comp :WCU C45705043 11101/2009 :1110112010 accident for setf-insured States: AZCA,GA,LA,MD,NV -I 0H,0R,RI,WA DESCRIPTION OF OPERATIQNSrLOCATIONSOVE141CLE&EXCLUSIONS ADDED BY ENUORSEMENT151PErIAL PROVISIONS City :C't of Fort Collins, Colorado, its officers and employees are inClUded as Additional InSUred (ifrequiredby conti-act) on Ike above General Liability Policy but only with --Plot 11 liability arising out of the operations of the Named Insured. ...... ... .. ...... CERTIFICATE HOLDER ATL-001763146-10 . ..... ... ..................... ... City of Fort Collins PO Box 580 Fort Collins, CO 80522 ............ ­­... CANCELLATION 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 70 DO 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIV155. Darlene Ciampitt ..... ........... ...... --- --- ---------------------- ................ 1998-2009 ACORD CORPORATION. All Right- Reserved The ACORD name and logo are registered marks of ACORD CCE Atlanta 7/13/2010 3:38:55 PM PAGE 4/006 Fax Server IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemenl(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the poticy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. CCE Atlanta 7/13/2010 3:38:55 PM PAGE 5/006 Fax Server ADDITIONAL INFORMATION ATL-001763146-10 DA7E lr7MrDD,YYy PRODUCER ..._ ......... 06/1812010 Marsh USA, Inc. Two Alliance Center 3560 Lenox Road, Suite 2400 Atlanta, GA 30326 Attn: Atlanta. CertRequest@marsh.cam Fax; 212-948-4321 504477—MAST-09-10 INSURERS AFFORDING COVERAGE NAIL # 'Coca-Cola Enterprises Inc. uasuRER F DBA Coca-Cola Bottling Company of Greeley ' irrsurreR c,: 1200 7th Avenue ............. _....._...........: _......__......... . ENSURER k Greeley. CO 80631 4112 _._......... ...... ...... ... ........-- ...... . rcvr i I95IJRER I; .... .... ... .... ..... ... ..... .... ....... ............ Specific Excess Workers Comp Continued: - - $500,000 each accident for MA, Not applicable to MI. ........ ........... ... ......... .......... CERTIFICATE MOLDER City of Fort Collins PO Box 580 Fort Collins, CO 80522 tnery q I IYE of Marsh USA Inc. Donna Clampilt r,