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HomeMy WebLinkAboutWING SHACK ENTERPRISES INC - INSURANCE CERTIFICATEWINGS-6 OP ID: B ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (M2/20 11/0/208 18 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 C N ACT Karen E. Siwek, CPA Brown & Brown Inc PHONE 970-482-7747 (Fa 970-4-4165 4532 Boardwalk Dr, Suite 200 A/c, No, E:t : AI, 84No): Fort Collins, CO 80525 -,MJkss. ksiWek(C_DbbC0_r­__.Corn Karen E. Siwek, CPA INSURED Wing Shack Enterprises, Inc. Edith Georgge 2990 West 29th Street, Unit A2 Greeley, CO 80631 F: Westfield Insurance r"nvEDAn00 rco Trcr!`AYE AO uADCD. oCtnclnki rJ1111AR11=110• 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 DDL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMBS A A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [ OCCUR CWP5054822 CWP8602741 11/15/2018 11/15/2018 11/15/2019 11/15/2019 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED 500,000 MEDEXP (Any oneperson) 5,000 PERSONAL R ADV INJURY 1,000,000 GEN'L AGGREGATE LI M IT APPLI ES PER: POLICY PRO l_ LOC JECT OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS -COMP/OP AGG 21000,000 A AUTOMOBILE LIABILITY X ANY AUTO AWNED S UTOS ONLY AUTOSULED HIRED NON -OWNED AUTOS ONLY AUTOS ONLY CWP5054822 11/15/2018 11/15/2019 COMBINED SINGLE LIMIT n 1,000,000 $ _ $ $ $ BODILY INJURY Perperson) BODILY INJURY Per accident PROPERTY AMAGE Per accident A UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE CWP5054822 11/15/2018 11/15/2019 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DIED I X I RETENTION $ 0 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N Mandatory In NH) EXCLUDED? n If yes, describe under DESCRIPTION OF OPERATIONS below N / A WCP5055634 11/15/2018 11/15/2019 PE ORH- E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Taste of Fort Collins June 9th-11th City of Ft Collins and Townsquare Lifestyle Events are included as additional insured per policy forms and conditions. CITYFT3 City of Ft Collins P O Box 5080 FT 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 Karen E. Siwek, CPA ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD