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HomeMy WebLinkAbout332904 JAG'S ENTERPRISES, INC - INSURANCE CERTIFICATE (2)ACORO� CERTIFICATE OF LIABILITY INSURANCE DATE(MM:DD.YVYV) 9/27/2019 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 CONTACT _ Commercial Risk SOIUtlOnS NAME:--- Kate Smothers - PHONE FA% 6600 E Hampden Ave Ste 200 303-996-7801 ac No: 303-757-7719 Denver CO 80224 nnn9E9s: ksmothers@crsdenver.com INSURED Jag's Enterprises, Inc 7951 VV 28th Street Greeley CO 80634 A: NAICO B: Pinnacol Assurance INSURER C : INSURER D : Iusuece c Insurance COVERAGES CERTIFICATE NUMBER: 1549721986 REVISION NUMBER: 41 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 ADDUSUB- - POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSID WVID POLICY NUMBER MM:DD%VVVY MMIDD/YYYY LIMITS A X I COMMERCIAL GENERAL LIABILITY Y MP19010105 1/27/2019 1/2712020 EACH OCCURRENCE I$1,OD0,000 CLAIMS -MADE X OCCUR _ PREMISES Ea M,,Lrii $100,000 $ 5.000 MED EXP (Any one person) $ 1,000,000 I I PERSONAL 8 ADV INJURY $2,000.000 GEN'L AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE POLICY X, R' `JJPECOT LOC i PRODUCTS -COMP/OPAGG $2,000,000 S OTHER. A AUTOMOBILE LIABILITY Y MP19010105 1/27/2019 111712121 _ COMBINED SINGLE LIMIT _(Ea. accdent $1.000.000 S X ANY AUTO BODILY INJURY (Per person) OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Par accident) S HIRED_^ NON OWNED X AUTOS ONLY X AUTOS ONLY PROPERTY _CPe acadenj AMAGE- $ UMBRELLA LIAR OCCUR EACHOCCURRENCE $ S EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEC RETENTIONS B WORKERS COMPENSATION 4146867 6/1/2019 611/2020 AND EMPLOYERS' LIABILITY YIN ANvPROPRIETORPARTNER EXECUTIVE OFFICERWEMBEREXCLUDED? NIA X STATUTE ERH E.L. EACH ACCIDENT --"- - $1.000,000 $1,000,000 (Mandatory In NH) E.L. DISEASE EA EMPLOYEE II es. It nee under DESCRIPTION OF OPERATIONS below E.L. DISEASE POLICY LIMIT $ 1.000,000 C Leased and Rented EquipDment ILM0707058 112712019 11172020 Special FormIACV/80%Coinsurance Omit 50,000 Deductible 1,000 DESCRIPTION OF OPERATIONS ; LOCATIONS' VEHICLES ACORD 101. Additional Remarks Schedule, may be attached it more space is required) RE 8998 Poudre Trail Spur at Lancer Drive City of Fort Collins Is included as additional insured for ongoing operations on the General Liability and included as additional insured on the Auto Liability with respect to operations of the named insured for the certificate holder as required by written contract All policy terms, conditions and exclusions apply. City of Fort Collins 300 Laporte Ave Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD of 4 5665