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HomeMy WebLinkAboutPEPSI-COLA METROPOLITAN BOTTLING COMPANY INC - INSURANCE CERTIFICATE (2)ACORD,. CERTIFICATE OF LIABILITY INSURANCE vuzms DATE (MM/DD01YY) 12/16/2013 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 policyjies) 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 2100 ROSS AVENUE, SUITE 1400 DALLAS TX 75201 214-969-6700 CONTACT NAME: AIC No FAX Ext : A/C No E-MAIL ADDRESS INSURER A: ACE American Insura ce COm anV 22667 INSURED PEPSI-COLA METROPOLITAN BOTTLING COMPANY, INC. 1327006 ONE PEPS IN WAY SOMERS NY 10589 INSURER B: Indemnin Insurance Co of North America 43575 NSURERC: INSURER INS RERE: N URER FF COVERAGES PEPSI01 b 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 Im TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF MMIDDIYYYY POLICY P LIMITS A GENERAL LIABILITY Y N HDOG27327825 I/I/2014 1/12015 EACH OCCURRENCE SOOOOOO X COMMERCIAL GENERAL LIABILITY CLNMSadADE M OCCUR DAMIREMA E TO RENTErence 2 OOO OOO MED EXP (Ary one rson 1,000 PERSONAL B AOV INJURY $ 5,000,000 GENERAL AGGREGATE s 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 5000000 PR0 POLICY17 F7 $ A AUTOMOBILE LABILITY N N ISAH08815185 1/12014 I/l2015 COMBINED SINGLE LIMIT (Es awdent) $ I0000000 X BODILY INJURY (Per person) $ XXXX}Q(}( ANY AUTO � ED AUTRINED SAUTOSULED BODILY INJURY (Per accidera $ XXXXXXX HIRED AUTOS NON -OWNED PROPERTY a"ide DAMAGE s XXXXXXX $XXXXXXX UMBRELLA LAB EXCESS LAB OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX DEO I I RETENTION $ $ AAND COMPENSATIONWORKERS EMPLOERSLABILIITY Y/N ANY PROPRETORPARNR/EXECUTVE OFFICERWEMSER EXCLUDED' N❑ ~dtlory M NH) d DESCRIPTIONOF O DESCRIPTION OF OPERATIONS trobx NIA N WLRC47874014(AOS WLRC4787402AA SCFC47874038 1/12014 I/l2014 P12015 1/12015 W2iTOTH- u E.L EACH ACCIDENT s 5.000000A E L DISEASE- EA EMPLOYEE 5,000,000 L. DIM815E-POLICY LIMIT s5,000,000 A A Excess Workers Compensation N N WCUC47874051 (OH -PC Metro WCUC47874063 WV -PC I/12014 1/l2014 1/12015 1/12015 _ WC Status ry Limits $5,000,BDO each accident $5,000,000 each ee for discase DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES;lA W_h ACORD 101, Additional Remarks Schedule, M more space Is requlred) CERTIFICATE HOLDERS INCLUDE: ITS OFFICERS, AGENTS AND EMPLOYEES. CERIIHICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 10988312 AUTHORIZED REPRESENTATIVE THE CITY OF FORT COLLINS 215 NORTH MASON STREET - 2NO FLOOR PO BOX 580 FORT COLLINS CO 80522-0580 i[(rt (r eel �- ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved The ACORD name and logo are registered marks of ACORD