HomeMy WebLinkAbout159994 ODELL BREWING - INSURANCE CERTIFICATE (3)ACC) CERTIFICATE OF LIABILITY INSURANCE
DATE5123/2019 Y)
05/2312019
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
NAME: CONTACT Dana Stewart, CIC, CISR
PHONE (g70) 266-7149 (FAX No : (970) 506-6845
A/C No Ext :
E-MAILss: DStewart@floodpeterson.com
PO Box 578
INSURER(S) AFFORDING COVERAGE
NAIC #
Greeley CO 80632
INSURER A: Charter Oak Fire Insurance Company
25615
INSURED
INSURER e : Travelers Property Casualty Company of America
25674
INSURER c : Pinnacol Assurance
41190
Odell Brewing Company
INSURER D :
800 E. Lincoln Avenue
INSURER E :
INSURER F
Fort Collins CO 80524
RAGES CERTIFICATE NUMBER: GL/AU/X5/WU/LL xti/ZUZU REVISION NUMBER:
COVE
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.
1 TR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
POLICY EFF
MM/DD
POLICY EXP
MM/DDlYY
LIMITS
1,000,000
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$
$ 100,000
CLAIMS -MADE ® OCCUR
PREMISES Ea occurrence
5,000
MED EXP (Any one person)
$
A
630-21-1193508-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 -COMPfOPAGG
2,000,000
$
PRO-
POLICY ❑ JECT LOC
$
OTHER:
EOacc den SINGLE LIMIT
$ 1,000,000
AUTOMOBILE LIABILITY
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
R
$
1
$ 10,000,000
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
B
EXCESS LIAR
CLAIMS -MADE
CUP-21-1193508-19-14
06/01/2019
06/01/2020
AGGREGATE
S 10,000,000
DED I I RETENTION $
$
PER H
WORKERS COMPENSATION
X STATUTE I I ER
E.L. EACH ACCIDENT
1,000,000
$
AND EMPLOYERS' LIABILITY Y / N
C
ANY PROPRIETORIPARTNER/EXECUTIVE
El
N / A
4210328
06101 /2019
06/01/2020
E.L. DISEASE - EA EMPLOYEE
1,000,000
$
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
1,000,000
$
Aggregate Limit
$2,000,000
q
Liquor Liability
L0-2H193508-COF-19
06/0112019
06/01/2020
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: Open House FoCo Cafe October 24th
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.
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 '� n
Fort Collins CO 80522-0580���_
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ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD