HomeMy WebLinkAbout159994 ODELL BREWING - INSURANCE CERTIFICATE (2)Aco ® CERTIFICATE OF LIABILITY INSURANCE
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DATE /23/20I19
05/23/2019
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
Flood and Peterson
PO Box 578
Greeley CO 80632
NAME: CONTACT Dana Stewart, CIC, CISR
PHONE (970) 266-7149 FAX : (970) 506-6845
A/C No Ext
E-MAIL DStewart@floodpeterson.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC
INSURER A: Charter Oak Fire Insurance Company
25615
INSURED
Odell Brewing Company
800 E. Lincoln Avenue
Fort Collins CO 80524
INSURER e : Travelers Property Casualty Company of America
25674
INSURER C : Pinnacol Assurance
41190
INSURER D :
INSURER E :
INSURER F :
rnv=taencc CERTIFICATE NUMBER GUAU/XSlWC/LL x6/2020 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
INSD
WVD
POLICY NUMBER
POLICY EFF
MMIDD
POLICY EXP
MM1DD/YYYY
LIMITS
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
DAMAGE TO RENTED
1 OO,OOD
CLAIMS -MADE ® OCCUR
PREMISES Ea occurrence
$
5,000
MED EXP (Any one person)
$
A
630-2H193508-COF-19
06/01/2019
06/01/2020
PERSONAL & ADV INJURY
$ 1,000,000
GENERAL AGGREGATE
$ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY El JECOT- LOC
OTHER:
COMBINED SINGLE LIMIT
$ 1,000,000
AUTOMOBILE LIABILITY
(Ea accident
BODILY INJURY (Per person)
$
ANY AUTO
BODILY INJURY (Per accident)
$
A
OWNED SCHEDULED
810-ON773698-19-14-G
06/01/2019
06/01/2020
AUTOS ONLY AUTOS
HIRED NON -OWNED
PROPERTY DAMAGE
Per accident
$
AUTOS ONLY AUTOS ONLY
H
s
I
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$ 10,000,000
B
EXCESS LIAB
CLAIMS MADE
CUP-21-1193508-19-14
06/01/2019
06/01/2020
AGGREGATE
$ 10,000,000
DED I I RETENTION $
$
WORKERS COMPENSATION
PER OTH-
STATUTE ER
AND EMPLOYERS' LIABILITY YIN
E.L. EACH ACCIDENT
1,ODD.00D
$
C
ANY PROPRIETOR/PARTNER/EXECUTIVE
N/A
4210328
06/01/2019
06(01/202D
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
OFFICER/MEMBEREXCLUDED?
(Mandatory In NH)
E.L. DISEASE - POLICY LIMIT
$ 1,000,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
Aggregate Limit
$2,000,000
q
Liquor Liability
630-2H193508-COF-19
06/01/2019
06101l2020
Each Common Cause
$1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required)
RE: Event: Colorado Marathon - May 1st, 2016
The City of Fort Collins, its officers, agents, employees and volunteers are included as Additional Insured as required by written contract with respects to
liability arising out of the above referenced event.
CERTIFICATE HULUEK rrr�a. c��nr rvr�
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Risk Management ACCORDANCE WITH THE POLICY PROVISIONS.
P.O. Box 580
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80522-0580 ���WuldlG7
(01988-2010 AGUKU CUKF'UKAI IUN. All rlgnis reserveu.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD