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HomeMy WebLinkAboutTHE CAKERY LLC - INSURANCE CERTIFICATEA4C"R" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) �i. 017/24/2019 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 CONTNAME Elizabeth Elizabeth A Kennedy PHONE . (719) 594-6883 ac No; (719) 532-9996 Western Insurance Solutions Inc E-MAIL beth@wisins.com ADDRESS: 4740 Flintrid Drive, Suite 115 9e INSURERS AFFORDING COVERAGE NAIC.If INSURER A: OHIO SECURITY INSURANCE COMPANY 24082 Colorado Springs, CO 80918 INSURED INSURERB: PINNACOL ASSURANCE 41190 INSURERC: The Cakery, LLC 3357 Mammoth Cir INSURER D: INSURER E : Wellington CO 80549 INSURER F: COVFRA(;FS CFRTIFICATF NIIMRFR- 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 TYPE OF INSURANCE ADDL',,SU POLICY EFF POLICY EXP LTR O POLICY NUMBER MMIDDIYYYY IY MMIDDYYY LIMITS X COMMERCIAL GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 X DAMAGE TO RENTED 300,000 CLAIMS -MADE OCCUR PREMISES fEa occurrence s MED EXP (Any one person) $ 15,000 PERSONAL & ADV INJURY $ 1,000,000 A X BKS58059292 08/08/2019 08/08/2020 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: G X POLICY E�7 LOC PRODUCTS -COMNOP AGG S 2,000,000 $ OTHER AUTOMOBILE LIABILITY _ COMBINED SINGLE LIMIT Es accident $ 1,000,000 BODILY INJURY (Per person) s ANY AUTO A OWNED SCHEDULED X BKS58059292 08/08/2019 08/08/2020 BODILY INJURY (Per accident) s AUTOS ONLY AUTOS PROPERTYDAMAGE Per accident S HIRED NON -OWNED X X _ AUTOS ONLY AUTOS ONLY s UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE s EXCESS LIAB CLAIMS -MADE NONE $ DIED RETENTIONS WORKERS COMPENSATION X PEATUTE OERN- AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 100,000 B OFFICER/MEMSER EXCLUDEDa N I A 4218517 07/25/2017 08/01 /2020 - (Mandatory In NH) E. L. DISEASE - EA EMPLOYED 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ 500.000 N/A NONE DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mom space Is required) The City of Fort Collins, it's directors, managers, sponsors, agents, and employees are additional insured regarding General & Auto Liability if required in a written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE For N Masan St Fort Collins CO 80524 © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD