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Home My WebLink AboutTHE HUMAN BEAN - INSURANCE CERTIFICATE----0aaa`N . SSBLUES-01 CERTIFICATE OF LIABILITY INSURANCE VMATHIA ) DATE (MM/020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION_ ONLY ANDCONFERSNO 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 endorsements . PRODUCER PFS Insurance Group 4848 Thompson Parkway Suite 200 Johnstown, CO 80534 ,NRAP.,kCT PP C; No, EK : (970) 635-9400 A/C, No :(970) 635-9401 Miss, info mypfsins_urance.com .INSURE S AFFORDING COVERAGE NAIC# INSURER A: Union. Insurance Coma 258" INSURED SS Blue Sky 2.0, LLC dba the Human Bean 3610 35th Avenue, unit 9 Evans, CO 80620 INSURER B : Plnnacol.Assurance CO 41190 INSURER C : INSURER D : INSURER E INSURER F : rnllCnwn_ec PCDTICICATC NI IMnCD• RFVISIAN NIIMRFR- 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 SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR CPA3124735-24 3/19/2020 3/19/2021 EACH OCCURRENCE $ 1,000,000 DAMAGE TO'RPREMISESBENTED occurrence$ 300,000 MED EXP (Any one erson $ 19,000 PERSONAL& ADV INJURY $ 11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY Pei LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULEDAUTOS ONLY ALITT SSWN AU S ONLY X. AUTOS ONLDY Ix CPA3124735-24 3/19/2020 3/19/2021 COMBINED SINGLE LIMIT -- "$ 1,;00Q,000 BODILY INJURY Per erson $ BODILY INJURY Per accident $ P P.ERTTYrrt AMAGE PPEAeeCH $ A X UMBRELLA LIAB EXCESSLIAB X OCCUR CLAIMS -MADE CPA3124735-24 _ 3/19/2020 3/19/2021 OCCURRENCE $ 2,0001000 AGGREGATE $ 21000,000 DED X RETENTION $ 0 B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETgOERp/PARTNER)EXECUTIVE Y/N FIdatory EIn NN) EXCLUDED? K. (m It es,.describeunder DESCRIPTION OF.OPERATIONS below_ N/A 4222176 3l1/2020 3N/2021 PER. OTH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYE S 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be aRached if more space is required) City of Fort Collins 215 North Mason St. Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE'CANCEI I Fn BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, REPRESENTATIVE ACORn 25120191031 ©1088-2015 ACORD The ACORD name and logo are registered marks of ACORD reserved.