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HomeMy WebLinkAboutCOOKIE MIKE LLC - INSURANCE CERTIFICATE--- , C:UUKI-1 A O" CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 10/30/2018 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 have ADDITIONAL INSURED provisions or 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 endorsements . PRODUCER 970-482-7747 Brown & Brown Inc 4532 Boardwalk Dr, Suite 200 CONTNAMEACT House Account PHONE 970�82-7747 FAX 970�84i165 A/c, No, Ext : (A/C, No): Fort Collins, CO 80525 UNLESS: House Account INSURERS AFFORDING COVERAGE NAIC # INSURER A: Transportation Insurance Co. 20494 INSURED Cookie Mike, LLC INSURER B, Property & Casualty Ins Co of 34690 123 N College Ave #106 Fort Collins, CO 80524-2489 INSURER C INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE N R: 121=VIQInM N E Us 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 TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [7X OCCUR Business Owners B4024288877 11/17/2018 11/17/2019 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED MSEoccurrence) $ 300,000 X MED EXP (Any oneperson) $ 10,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO LOC JECT GENERAL AGGREGATE 2,000,000 PRODUCTS - COMP/OPAGG 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT BODILY INJURY Per erson ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident pPe�acEcRdentDAMAGE $ AUU CN ED AUTOS ONLY L - 1$ UMBRELLA LIAR HOCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAR CLAIMS -MADE DED RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A 34WECIC8886 03/01/2018 03101/2019 X I STEARTUTE I I OTH- E.L. EACH ACCIDENT 100,000 E.L DISEASE -EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT 500,000 I PROPERTY 234,333 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) L93ji1I City of Fort Collins PO Box 580 Fort Collins, CO 80524 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 S -G�w2_ ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD