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HomeMy WebLinkAboutKLM ENTERTAINMENT LLC DBA REPICCI'S ITALIAN ICE & - INSURANCE CERTIFICATEA�� m DATE(MM/DDIYYY) CERTIFICATE OF LIABILITY INSURANCE 5/21/2019 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 endorsement(s). PRODUCER Liberty CONTACT Mutual insurance NAME: PO Box 188065 PHONE No. EXt : 800-962-7132 a/c No): 800-845-3666 Fairfield. OH 45018 1 E-MAIL _ _... AFFORDING COVERAGE 24082 INSURED INSURER B : KLM Entertainment LLC DBA Repicc" Italian Ice & Gelato Of Northern Colorado INSURERC: 765 Rodgers Cir INSURERD: Platteville CO 80651 INSURERE: INSURER F : nw�owrcc !"COTICl/"ATC AIIIItaQCD• Aoonrrion RFVICI(1N NIIMRFR• 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. IN SIR LTR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF MM/DDIYYYY POLICY EXP MM/DDIYYVY LIMITS A �/ COMMERCIAL GENERAL LIABILITY ✓ BLS58024435 5/23/2019 5/23/2020 EACH OCCURRENCE .._ $1,000,000DAMAGE CLAIMS -MADE a OCCUR TO RENTEr�_ PREMISES Ea occurrence) $ 300,000 MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 ✓ POLICY PRO JECT ❑ LOC $ OTHER A AUTOMOBILE LIABILITY ✓ BAS58024435 6/30/2019 6/30/2020 COMBINED sBINEDtSINGLE LIMIT $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO ✓ OS ONLY SCHEDULED AUTOS HIRED NON -OWNED ✓ AUTOS ONLY ✓ AUTOS ONLY BODILY INJURY (Per accident) $ PROPERTYDAMAGE $ UMBRELLA LAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LAB CLAIMS -MADE DED 7 RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANYPROPRIETOR/PARTNER/EXECUTIVE PER OTH- STATUTE ER $ _. E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? ❑ (Mandatory in NH) NIA E.L. DISEASE - EA EMPLOYEE $ _ E.L. DISEASE -POLICY LIMIT I $ If yes, describe under DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) City of Fort Collins, its directors, managers, sponsors, agents, and employees are listed as Additional Insured if required by written contract or written agreement subject to Auto Liability and General Liability Blanket Additional Insured Provision, per forms CA8501 and CG8810. CERTIFICATE HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 215 N Mason St ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins CO 80524 AUTHORIZED REPRESENTATIVE Alicia Smith © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD 48809782 1 58024435 1 19-20 Master Certificate I Alicia Smith 1 5/21/2019 10:12:08 AM (EDT) I Page 1 of 18