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HomeMy WebLinkAboutSS BLUE SKY LLC DBA THE HUMAN BEAN - INSURANCE CERTIFICATESSBLUES-01 VMATHIAS '4coRO CERTIFICATE OF LIABILITY INSURANCE DAT3812 DlYYYY) 18/2019 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 PFS Insurance Group 4848 Thompson Parkway Suite 200 Johnstown, CO 80534 INSURED n/cN. Frrr (9701635-9400 TAT_ Ns,,(970) 635-9401 I SS Blue Sky 2.0, LLC dba the Human Bean INSURER C 3610 35th Avenue, Unit 9 INSURER D Evans, CO 80620 INSURER E : INSURER F nsurance.com C« 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 LTIRA TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE [ X] OCCUR CPA3124735-22 3/19/2019 3/19/2020 EACH OCCURRENCE $ 1,000,000 DAMETORENTED ES $ 300,000 MED EXP (Any oneperson) $ 1,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY jra LOC OTHER. GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS X HIRED X NON -AWNED AUTOS ONLY AUTOS ONLY CPA3124735-22 3/19/2019 3/19/2020 INED COMBcid_entSINGLE LIMIT $ 1,000,000 BODILY INJURY Perperson) $ BODILY INJURY Per accident $ PROPERTY DAMAGE Per accident $ A X UMBRELLA LAB EXCESS LAB X OCCUR CLAIMS -MADE CPA3124735-22 3/19/2019 3/19/2020 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DIED I X I RETENTION $ 0 $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ OFFICER/MEMBEREXCLUDED> (Mandatory in NH) If es describe under DESCRIPTION OF OPERATIONS below N/A TBD 3/1/2019 3/1/2020 PER OTH- AT T R E.L. EACH ACCIDENT 500,000 $ E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICY LIMIT 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CHa;IIIaLail—IV I�1111GPJ45J71i1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Y ACCORDANCE WITH THE POLICY PROVISIONS. 215 North Mason St. Fort Collins, CO 80522 AUTHORIZED REPRESENTATIVE POCA 0. 7/w ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD