HomeMy WebLinkAboutTHE BURRITO DREAM - INSURANCE CERTIFICATE (6)A� o® CERTIFICATE OF LIABILITY INSURANCE DATE(01/DOIYYYY)
03II2012
PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION
Jennifer Richardson Insurance Agency, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
500 E Oak St HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Ft Collins, CO 80524
INSURED
The Burrito Dream I/
610 Locust St
Ft Collins, CO 80524
C�Z�Pl7:7_TH�'!
INSURERS AFFORDING COVERAGE NAIC #
INSURERA. Colonial General Insurance _
INSURER B'.
INSURER C.
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.
INS
LTR
ADD'
INSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DDIYY
POLICY EXPIRATION
DATE MMIODNY
LIMITS
A
GENERAL LIABILITY
%� COMMERCIAL GENERAL LIABILITY
CPS1544734
02/28/2012
02/28/2013
EACH OCCURRENCE
S 1,000,000
-DAJArrT0-PTNTEff100,000
PREMISES (Ed dcoursnoe)
$
MED EXP (Any one parson)
$ 5,000
CLAIMS MADE �X OCCUR
PERSONAL B ADV INJURY
S 1,000,000
GENERAL AGGREGATE
$ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER.
PRODUCTS - COMPIOP AGO
S 1.000,000
$
—1 POLICY JECCT LOC
AUTOMOBILE
LIABILITY
ANY AUTO
COMBINED SINGLE LIMIT
(Ea accHenp
E
BODILY INJURY
(Per parson)
$
ALL OWNED AUTOS
SCHEDULED AUTOS
BODILY INJURY
(Per ao,ndenl)
$
HIRED AUTOS
NON -OWNED AUTOS
I
PROPERTY DAMAGE
(Perecciden)
$
GARAGE LIABILITY
AUTO ONLYEAACCIDENT
S
OTHER THAN EA ACC
$ —
ANY AUTO
$
AUTOONLY. AGG
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
! AGGREGATE
S
OCCUR CI -AIMS MADE
E
s —
DEDUCTIBLE
RETENTION S
S
WORKERS COMPENSATION AND
A U- OTH-
OR,LIMITS ER
E.l. EACH ACCIDENT
I S
EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNERIEXECUTIVE
OFFICERIMEMBER EXCLUDED?
E. L. DISEASE EA EMPLOYE
$
E.L. DISEASE -POLICY LIMIT
1 $
If yes, describe under
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I V EHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Food cart vendor
City of Ft Collins
281 North College Avenue
Ft Collins, CO 80524
lsamuelson@fcgOv.com
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURER, ITS AGENTS OR