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HomeMy WebLinkAboutPEPSI-COLA METROPOLITAN BOTTLING COMPANY - INSURANCE CERTIFICATEACORD,CERTIFICATE OF LIABILITY INSURANCE CERTIFICATE1n/zo13 DATE 12/6/206/201 I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, 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). PRODUCER LOCKTON COMPANIES, LLC-N DALLAS 717 N. HARWOOD, LB#27 DALLAS TX 75201 214-969-6700 CONTACT NAME: PHONEwe No Ext : A C No E-MAIL ADDRES& INSURERINSURERISI AFFORDINGCOVERAGE NAIC INSURER A: ACE American Insurance Company 22667 INSURED PEPSI-COLA METROPOLITAN BOTTLING COMPANY, INC. 1327006 PEPSICO, INC. ONE PEPSI WAY SOMERS NY 10589 INSURER B: Indemnity Insurance Co of North America 43575 INSURER C INSURER D : IN RER E N RER F:: COVERAGES PEPS101b GO CERTIFICATE NUMBER: 10988312 REVISION NUMBER- XXXXXXX 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MM/DD/VYYY(MMIODfYYYY POLICY EXP LIMITS p, GENERAL LIABILITY Y N HDOG25533811 I/1/2012 1/1/2013 EACH OCCURRENCE 5,000,000 X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F_x1 OCCUR PREMISETOEDomu,,ence 2000000 MED UP (Any oneperson) 10,000 PERSONAL SADV INJURY s 5,000,000 GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 5000000 POLICYPRO- PRO- LOC $ A AUTOMOBILE LIABILITY N N ISAH08693626 1/l/2012 1/1/2013 COMBINED SINGLE LIMITEar accidenO $ 10000000 X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO ALTUS NED AUTOSULED BODILY INJURY (Per accdent $ XXXXXXX HIRED AUTOS AUTOSWNED PeOeccr DAMAGE s XXXXXXX $XXXXXXX UMBRELLA LIAR OCCUR EACH OCCURRENCE s XXXXXXX EXCESS LIAB CLAIMS -MADE NOT APPLICABLE AGGREGATE $ XXXXXXX DED I I RETENTION$ $ B '�' A NSATIONSTAIT WORKERS AND EMPLO ERSELIABILIITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN OFFICERIMEMBER EXCLUDED' � NIA N WLRC46772696(AOS) WLRC46772702(AZ,CA,MA) SGFG46]72]14( I) 1/1/2012 1/1/2012 1/1/2012 1/1/2013 1/1/2013 1/I/2013 OTH- X TI Fri E.L. EACH ACCIDENT $ 5000000 E.L. DISEASE EA EMPLOYEE 5,000,000 If ms d or, in INHl uyes PTJON OFer DESCRIPTION OF OPERATIONS MIaw EL DISEAbE- POLICY LIMIT s ✓COO OOO A A Escess.WRrkers rompcvsztion__ Ld N -WCUC46772726(OH,WA-F-L WCUC46772738(OH-PC Metro !/1!2012 I/1/2012 !/!!20!3 I/I/2013 WC Statute,, LLmM $5,000,000 each accident A WCUC4677274A(WV-PC Metr )1/1/20I2 I/l/2013 $5,000,000 each ee for disease DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I(Attach ACERB 101, Additional Remarks Schedule, if more space is required) THE CITY OF FORT COLLINS. ITS OFFICERS, AGENTS AND EMPLOYEES ARE INCLUDED AS ADDITIONAL INSURED WHERE REQUIRED UNDER CONTRACT OR AGREEMENT_ 10988312 THE CITY OF FORT COLLINS 215 NORTH MASON STREET - 2ND FLOOR PO BOX 580 FORT COLLINS CO80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All The ACORD name and logo are registered marks of ACORD