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HomeMy WebLinkAboutNOCO FROZEN TREATS LLC - INSURANCE CERTIFICATE (2)KONAI-1 OP ID: KB s lla R CERTIFICATE OF LIABILITY INSURANCE �� DATE 03/16/2015 ) 03/16/2015 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 Renaissance Insurance Group P O Box 478 101 E Main Street Windsor, CO 80550 Michael T Ball CONTACT Michael T Ball PHONE 970-674-8825 i� No): 970-674-8826 (A/C, No Exr A DRESS: mball@reninsurance.com INSURE S AFFORDING COVERAGE NAIL• INSURER A: Allied Insurance Company INSURED Kona Ice of Northern Colorado NoCo Frozen Treats, LLC dba 5242 Silverwood Drive INSURER B : INSURERC: Johnstown, CO 80534 INSURERD: INSURER E : INSURER F : COVFRACFS 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. INSR LTR TYPE OF INSURANCE ADD POLICY NUMBER MM DDY EFF MPMIDD/YYtYV EP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR X ACPGLA03016572685 03/09/2015 03/09/2016 EACH OCCURRENCE $ 1,000,000 PREMISES Ea occurrence $ 100,00 MED EXP (Any one person) $ 6,0 PERSONAL B ADV INJURY $ 1,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JECT LOC OTHER: GENERAL AGGREGATE $ 2,000,00 PRODUCTS - COMP/OP AGG $ 2,000,00 $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS X X NON -OWNED HIRED AUTOS AUTOS ACPBAPC3016572685 03/09/2015 03/09/2016 CEOa eBBIINdEDISINGLE LIMIT $ 1,000,00 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per awdent $ S A X UMBRELLAU48 EXCESS LIAB X OCCUR CLAIMB•MADE CPCAA3016572685 03/09/2015 03/09/2016 EACH OCCURRENCE $ 1,000,00 AGGREGATE $ 1,000,00 DED I X I RETENTION$ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ,, / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICERIMEMBER EXCLUDED? (Mandatory in NH) H yas, describe ondar DESCRIPTION OF OPERATIONS below N/A PER H- STATUTE ER T E.L. EACH ACCIDENT Is E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE -POLICY LIMIT I $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarl s Schedule, may be attached it more space is requlred) Certificate Wording Subject to Policy Forms, Conditions, Definitions and Exclusions. Certificate Holder is an Additional Insured Regarding the General Liability and per Written Contract. CERTIFICATE 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. City of Fort Collins 215 Mason St., 2nd Floor Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE ��1Ldsu/...iLdJ✓tOuL '�"" 7 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD