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Home My WebLink AboutTUMBLEWEED SUPER TASTY TREATS - INSURANCE CERTIFICATE (5)From: Morgan Fugate At: Brown & Brown Insurance of Colorado FaxID: (970) 484-4165 To: City of Fort Collins Date: 7/192012 04:16 PM Page: 1 of 1 gCOR� CERTIFICATE OF LIABILITY INSURANCE OP ID FM 07/F 0,'M/DDM Y) 19/12 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 NAMEPHONE I-AX (A/C, No, Ext): (A/C, No): Brown & Brown Inc mi ADDRESS: 4532 Boardwalk Dr, Suite 200 Fort Collins CO 80525 CusTOMERID#: TUMBL-1 Phone:970-482-7747 Fax:970-484-4165 INSURER(S) AFFORDING COVERAGE NAIL INSURED INSURER A Tumbleweed Super Tasty Treats David Ammann dba INSURER B: INSURER C: 525 Peterson Street Fort Collins CO 80524-3137 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSIbi LTR TYPE OF INSURANCE A- INSR 1 WVD POLICY NUMBER FULIV (MM/DDM'YY) (MM/DD/1'1'YY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1:1 OCCUR X 7487090 06/28/12 06/28/13 EACH OCCURRENCE $ 500,000 PREMISES (Ea occurrence) $300,000 MED FAR (Any one person) $ 10,000 PERSONAL & ADV INJURY $500,000 GENERAL AGGREGATE $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY JET LOC PRODUCTS - COMP/OPAGO $1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOWPARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below /A - TORV LIMITS ER E L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Concessionaires. Certificate Holder is named as Additional Insured as respects the General Liability and operations of the named insured. Attn: David Carey FAX: 970-221-6707 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FTCOLLI I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ft. Collins AUTHORIZED REPRESENTA David Carey 281 N College Avenue House Account ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD From: Morgan Fugate At: Brown & Brown Insurance of Colorado FaxID: (970) 484-4165 To: City of Fort Collins Date: 7/192012 04:16 PM Page: 1 of 1 gCOR� CERTIFICATE OF LIABILITY INSURANCE OP ID FM 07/F 0,'M/DDM Y) 19/12 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 NAMEPHONE I-AX (A/C, No, Ext): (A/C, No): Brown & Brown Inc mi ADDRESS: 4532 Boardwalk Dr, Suite 200 Fort Collins CO 80525 CusTOMERID#: TUMBL-1 Phone:970-482-7747 Fax:970-484-4165 INSURER(S) AFFORDING COVERAGE NAIL INSURED INSURER A Tumbleweed Super Tasty Treats David Ammann dba INSURER B: INSURER C: 525 Peterson Street Fort Collins CO 80524-3137 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 CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSIbi LTR TYPE OF INSURANCE A- INSR 1 WVD POLICY NUMBER FULIV (MM/DDM'YY) (MM/DD/1'1'YY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE 1:1 OCCUR X 7487090 06/28/12 06/28/13 EACH OCCURRENCE $ 500,000 PREMISES (Ea occurrence) $300,000 MED FAR (Any one person) $ 10,000 PERSONAL & ADV INJURY $500,000 GENERAL AGGREGATE $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER POLICY JET LOC PRODUCTS - COMP/OPAGO $1,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOWPARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below /A - TORV LIMITS ER E L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Concessionaires. Certificate Holder is named as Additional Insured as respects the General Liability and operations of the named insured. Attn: David Carey FAX: 970-221-6707 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE FTCOLLI I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Ft. Collins AUTHORIZED REPRESENTA David Carey 281 N College Avenue House Account ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD