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HomeMy WebLinkAboutLUCKY FINS LLC - INSURANCE CERTIFICATEuuenvf: ll-Latsl / L.UUr%YI-IN ACORD. CERTIFICATE OF LIABILITY INSURANCE FFATE(MM/DD/YYYY) 11 /07/2018 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 any rights to the certificate holder in lieu of such endorsement(s). ONTACT PRODUCER NAME: Tracy Taylor USI Insurance Services NW a"4"N,:208-917-5692 "„ 866-613-3129 16231 North Brinson St Ste 150 E-MAIL traC to for usi.cim ADDRESS: y Y Nampa, ID 83687 INSURER(S) AFFORDING COVERAGE NAICn 208 917-5680 INSURER A: Depositors Insrmance Compaq 42587 INSURED INSURER B • AmTrust Insurance Company of Kansas 15954 Lucky Fins LLC 801 West Main St #107 Boise, ID 83702 INSURER C 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. INSR LTR TYPE OF INSURANCE ADDLISUBR INSR WVD POLICY NUMBER POLICY EFF MM/DD/YYY 1 /01 /2018 POLICY EXP MM/DD/YYY 11/01/2019 LIMITS EACH OCCURRENCE $1 000 000 A XI COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR X ACP301849679 pA�pGET RENTED PREMISES Ea occurrence $300,00.0 $5,000 $1,000,000 IVIED EXP (Any one person) PERSONAL & ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: PRO- POLICY I PRO- LOC OTHER: GENERAL AGGREGATE $2,000,000 X PRODUCTS - COMP/OP AGG $ 2,000,000 $ A AUTOMOBILE LIABILITY ANY AUTO I OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY X NON -OWNED AUTOS ONLY ACP301849679 ACP301849679 KWC1147845 11/01/2018 11/01/2019 Eaa lid.nSINGLELIMIT 1000000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 11 /01 /2018:11/01/2019 11/08/2018 EACH OCCURRENCE s7,000,000 AGGREGATE s7,000,000 DED X RETENTION $7000000 _ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes describe under DESCRIPTION OF OPERATIONS below N/A 11/08/201 X PER OTH- E.L. EACH ACCIDENT $500000 E.L. DISEASE - EA EMPLOYEE $500,000 $500,000 E.L. DISEASE - POLICY LIMIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) ** Workers Comp Information ** Proprietors/Partners/Executive Officers/Members Excluded: Derek Hood, Owner Fort Collins City Clerk 300 Laporte Ave. Fort Collins, CO 80521 L;ANL;tLLA I ILIN 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 r ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD