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HomeMy WebLinkAboutFORT COLLINS BREWERY - INSURANCE CERTIFICATEA� �® CERTIFICATE OF LIABILITY INSURANCE D0/11/2012 1o/11/zolz 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 First Mainstreet Insurance, LLC 275 S. Main Street, Suite 100 P.Q. BOX 847 Longmont CO 80502 CONTACT pat Deaver NAME: PHONE 1 (303) 776-5122 ac No. (303)776-5495 �EbmpAgLESS,pdeaver@firstmainstreat.com INSURERS AFFORDING COVERAGE NAICN INSURER A.Wes tfield Insurance Companies INSURED Ambiance Inc DBA: Fort Collins Brewery 1020 E. Lincoln Ave Fort Collins CO 80524 INSURER B:Plnnacol Assurance INSURER C: INSURER D: INSURER E: INSURER F: COVERAGES -- CERTIFICATE NUMBER:12-13 GL AL WC LL 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 CLAIMS. INSR TR TYPE OF INSURANCEi Wen POLICY NUMBER (MMIDDNYYYI fMMIDDNYYYILIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurnerroin $ 500,000 X COMMERCIAL GENERAL LIABILITY A CLAIMS -MADE OCCUR rRA7645708 10/6/2012 10/6/2013 MED EXP(Any one person) $ 15,000 PERSONAL B ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AGG $ 2,000,000 $ X POLICY PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accitlent 11000,000 BODILY INJURY (Per person) $ A X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X X NON -OWNED HIRED AUTOS AUTOS rRA7645708 10/6/2012 10/6/2013 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accitlent $ Medical payments $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DIED I I RETENTION $ $ B WORKERS COMPENSATION yI WC STATU- 01 IT RY LIMITS ER AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L. EACH ACCIDENT $ 100 000 MFFICERI�mR EXCLUDED? _ _� (MandatoryNi NIA '127155 L/1/2012 1/1/2013 E. L. DISEASE -EA EMPLOYE $ - 100 000 E.L. DISEASE - POLICY LIMIT $ 500 000 s describe under DIf ESCRIPTION OF OPERATIONS below A Liquor Liability TRA7645708 0/6/2012 0/6/2013 Each common cause $1,000,000 Aggregate LIMA $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 161; Additional Remarks Schedule, if more space is required) City of Fort Collins and Fort Collins DDA as Additional Insured if required by written contract per General Liability policy form.--� Lef 9CU IaV --I I a i i YJa L/ City of Fort Collins PO Box 580 Fort Collins, CO 80522 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 REPRESENTATIVE ACORD 25 (2010/05) INS025 (201005).01 Pat Deaver/PAT /04111- ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD