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HomeMy WebLinkAboutWING SHACK ENTERPRISES INC - INSURANCE CERTIFICATE (4)WINGS-6 OP I `ACORQ" FDATE1(jM0.1DD1YYYY) CERTIFICATE OF LIABILITY INSURANCE 2/2018 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 . 970-482-7747 CONTACT Karen E. Siwek, CPA PRODUCER NAM : Brown & Brown Inc PHONE 970-482-7747 FAX 970-484-4165 4532 Boardwalk Dr, Suite 200 (A/C, No, Ext): (AIC, No Fort Collins, CO 80525 A siwe co ora o.com KSren E. Siwek, CPA INSURED Wing Shack Enterprises, Inc. Edith George 2990 West 29th Street, Unit A2 Greeley, CO 80631 INSURER F : Westfield Insurance 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 LTRMMIDDIYYYYI TYPE OF INSURANCE DDL NSOPOLICY UBR NUMBER POLICY EFF POLICY EXP LIMITS A A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR CWP5054822 CWP8602741 11115/2018 11/15/2018 11/1512019 11/15/2019 EACH OCCURRENCE 1,000,000 PREMSES (E.GE TO RENTED occurrence) SOO,000 MEDEXP (Any oneperson) 5,000 PERSONAL & ADV INJURY 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ❑ jE LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS -COMP/OP AGG 2,000,000 A AUTOMOBILE LIABILITYnt) X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS AUTOS ONLY NOS AUTOONLOY CWP5054822 11/15/2018 11/15/2019 EOMaBINE�D SINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY AMAGE Per accident $ - A UMBRELLA LAB EXCESS LIAB OCCUR CWP5054822 11/15/2018 11M5/2019 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 _EICLAIMS-MADE DED TX RETENTION $ 0 A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ FFICER/MEMBER EXCLUDED? Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA WCP5055634 11/15/2018 11/15/2019 OTH- PER TE ER E.L. EACH ACCIDENT 1,000,000 E.L. DISEASE - EA EMPLOYE 1,000,000 E.L. DISEASE -POLICY LIMIT 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) FoCO Food Truck Rally is included as additional insured per policy forms and conditions on page 2. CITYFC1 FoCO Food Truck Rally 281 N. College Ave 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 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