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Home My WebLink AboutAMERICA'S VARIETY FOOD CART LLC - INSURANCE CERTIFICATEACD a�Q® CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 8/11/2014 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 INSURERS), 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 WESTERN INSURANCE SOLUTIONS INC 4740 Flintridge Dr Ste 115 Colorado Springs, CO 80918 CONTACT NAME. Beth Kenned PNHONoE,�: (719)594-6883 FAIG,ND.(719)532-9996 MA AD DRESS:service@wisins.com INSURER(9) AFFORDING COVERAGE NAICY INSURER A'. pinnacol Assurance 41190 INSURED America r s Variety Food Cart LLC INSURER B Ohio Security Insurance Compan 24082 3518 Worwick Dr INSURER C: Fort Collins, CO 80525 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 CLAIMS. ICY OTA TYPE OF INSURANCE AiNSO WD POLICY NUMBER MM DD YVVY EXP MM DD YYYY LIMITS X COMMERCIAL GENERAL LIAIRLITY CLAIMS -MADE CI OCCUR EACH OCCURRENCE $ 1 OOO OOO PREMISES Ea occurrence $ 300 OOO MED EXP(My one person) $ 15,000 - PERSONAL B ADV INJURY $ 1,000,000 B X BKS55723791 9/13/2014 9/13/2015 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY C ECT CI LOG GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER'. AUTOMOBILE LIABILITY GUMBINED Ea accident $ 1,000,000 BODILY INJURY (Per person) $ A ANYAUTO ALL OWNED SCHEDULED AUTOS AUTOS HIRED AUTOS X NON -OWNED BKS55723791 09/13/2014 09/13/2015 BODILY INJURY (Per accident) $ X per accideniDAMA $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE NONE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION$ g A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ IMandam,y 1r NN) f yes, describe under DESCRIPTION OF OPERATIONS below NIA 4171480 2/13/2014 2/1/2D1'rJ - X STATUTE ER E. L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT I $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) Certificate holder is an additonal insured for General Liability if required by written contract or agreement CERTIFICATE HOLDER CANCELLATION City of Fort Collins 215 N. Mason St 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. I AUTHORIZED REPRESENT 01988-2013 ACORD CORPORATION. All rights reserved. ACORD25(2013/04) The ACORD name and logo are registered marks of ACORD