HomeMy WebLinkAboutVENDING SERVICES OF COLORADO INC - INSURANCE CERTIFICATEj,�� CERTIFICATE OF LIABILITY INSURANCE OP ID KA DATE(MMIDD/Yr
THIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 4 /1
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
"-y%re=I "w= De enaorsea. If SUBROGATION , s ect to
the terms and conditions of the policy, certain polities may require an endorsemm
ent A statement on this certificate does not confer rights to the
certificate holder in 6eu of such endorsement(s).
Brown. & Brown Inc
125 8 Howes, 5th Floor
P O Box 2226
Fort Collins CO 80522-2226
Phone:970-482-7747 Fax:970-484-4165
INSURED
Vending Services of Colorado
Inc
544� Boeincr Dr
Loveland CO 80538
CUSTOMER ID t: VEND I -1
INSURERS) A�sSuranCeORDING COVERAGE NAIC t
INWRERA: Pinnacol Com an 41190
INSURERS: cpoeito:. na Company 42587
INSURER C :
INSURER D :
INSURER E :
INSURER F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT 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 CONDMONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TR TYPE OF INSURANCE INSR--
GENERAL uABIUN ---
B COMMERCIAL GENERAL LIABILITY ACPBPWD7504279024
CLAIMS -MADE OCCUR
X Business Owners
GEML AGGREGATE LIMIT APPLIES PER: -
POLICY PRO-
JECT LOC
AUTOMOBILE LIABILITY
B X ANY AUTO CPBAM7504279024
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
UMBRELLALWB HCLA—,.,
OCCUR
EXCESS LIAR
DEDUCTIBLE
9/09 112/19/10
12/19/09 112/19/10
A H ERS COMPF_N8ATION
AND EMPLOYERS LIABILITY YIN 04021 10/01/10 10/01/11
ANY PROPRIETORIPARTNER/EXEC
OFFICER/MEMBEREXCLUDED? IA
(Myyaeenssdatory In NH)
be und
DESG�RIPTITION OF OPERATIONS below
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, A Monal Remarks Schedule, H more Vending service - Food 6 Soft Drinks space Is required)
CERTIFICATE HOLDER CANCELLATION
LIMITS
EACH OCCURRENCE
$ 1 Q O Q Q Q 0
PREMISI S ( Ea occurrence
$ 300000
MED EXP (My one person)
$ 5000
PERSONAL 3 ADV INJURY
$
GENERAL AGGREGATE
$ 2000000
PRODUCTS -COMP/OPAGG
$
COMBINED SINGLE LIMIT
(Ea accident)
$1, 000, 000
BODILY INJURY (Per person)
$
BODILY INJURY (Per accident) $
PROPERTY DAMAGE
(Per accident)
$
EACH OCCURRENCE $
AGGREGATE $
EL EACH ACCIDENT $ 100000
EL DISEASE-EAEMPLO $ jQQQQQ
EEL
LIMIT $ 500000
PROPERTY 103000
C I TYF10 ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
City of Fort Collins
Purchasing Department AUTHORIgOREPRESENTATIVE
215 N. Mason St.
Fort Collins CO 80521 J,
ACORD 25 (2009(09) The ACORD name and logo are regl ed marks of oRe RATION. All rights reserved.