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HomeMy WebLinkAboutWING SHACK ENTERPRISES INC - INSURANCE CERTIFICATE (5)CERTIFICA THIS CERTIFICATE IS ISSUED AS A MATTER OF INFO CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA1 WINGS-5 OP ID -A OF LIABILITY INSURANCE DATE(MM/DDfYYYY) 11/12/2019 TION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS .Y AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder Is an ADDITIONAL I INSURED, the pollcy(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 riahts to the certificate holder in lieu of such endorsement(s). m & Brown Inc Boardwalk Dr, Suite 200 Collins, CO 80525 n E. Siwek, CPA, CIC INSURED Wing Shack Enterprises, Inc. Edith George 2990 West 29th Street, Unit A2 Greeley; CO 80631 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TO CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE IN EXCLUSIONS AND CONDITIONSOF SUCH POLICIES. LIMITS ' TYPE OF INSURANCE ANDcn unm MERCIAL RAL ITY ( =MCLAIMS-MADE E� OCCLUR C"S 970-4824747 ONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS E AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, MAY HAVE BEEN REDUCED BY PAID CLAIMS. 11115/2019111/15/2020 1 L AGGREGATE LIMIT APPLIES PER: POLICY O JECT LOC AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUUTNOSyyryEp AUTOS ONLY AUTO ONLY UMBRELLA UAB 7L OCCUR EXCESS LIAB CLAIMS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNERIEXECUTIVE WQFE%MEMBERp EXCLUDED? NIA (Mandatory In NH) 11116/201911111512020 1111512019111 /15/2610 11115M619111 /1512020 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) amity of Fort Collins is included as additional insured per policy forms and conditions on page 2: w�..�...w. t� 1.i . � I ^AAVPOI I Arrnsr CITYF10 — SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THERE6F;..N0T10E WILL BE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of fort Collins 215 N. Mason St Fort Collins, CO 80521 REPRESENTATIVE KgrenQE. CPA, ICiiren E. Siwek, CPA, CIC ACORD 25 (2016/03) ©1933-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD No Text