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HomeMy WebLinkAboutTHE HUMAN BEAN - INSURANCE CERTIFICATE (2)SSBLUES-01 kle� ® CERTIFICATE OF LIABILITY INSURANCE DA3/19/2(MMMDr& I 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 COVERAGEAFFORDED 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 § . PRODUCER PFS Insurance Group 4848 Thompson Parkes. ay Suite 200 Johnst6m, CO 80534 C NTACT P"ONN Ft): (970) 636-9400 (FAX No:(970 635-9401 -M aL . info mypfsinsurance.com INSURERS AFFORDING COVERAGE' NAIC 0 INSURER A: Union Insurance: Company 258" INSURED SS Blue Sky 2.0, LLC dba the Human Bean Coffee Truck, LLC 3610 35th Ave Unit 9 Evans, CO 80620 INSURER B : Pinnacol Assurance Co 41190 INSURER C : INSURER D : INSURER E INSURER F : rr%V=0AJI1oc rr-CMCIrATC NI IMIRGR• 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 SUER POIJCY.NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FX] OCCUR CPA3124735-24 3/19/2020 3/19/2021 EACH OCCURRENCE $ 1,000,000 DPREMISES (Ea gmumitace)AMAGE TO RENTED $ 300,000 MED EXP (Any one rson $ 10,000 PERSONAL B ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY JPPf LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2r000,000 A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AURTN ONLY ALIT TOpSWNE X AUTOS ONLY X AUTOS ONLDY CPA3124735-24 3/19/2020 3/19/2021 COMBINED (Ea accide SINGLE LIMIT $ 1 �000;000 BODILY INJURY Per person)$ BODILY INJURY Per accident $ (Per, PROPERTY,? AMAGE $ A X UMBRELLA LIAB EXCESS LIAB X. OCCUR CLAIMS -MADE CPA3124735-24 3/19/2020 3/19/2021 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DEC) I X I RETENTION $ B WORXERS.COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR?PARTNERIEXECUTIVE Y❑ F MEER/,M R� EXCLUDED? deto 1 If y"es, desvibe under DESCRIPTION OF OPERATIONS below NIA 4222176 3/1/2020 3/1/2021 TATLITE.._ PER OTH- E.L. EACH ACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,0Q0 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached N more space Is required( rcerlelrATe U^I nco rANrPI I A71r1N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. Cityof Fort Collins THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 215'North Mason Street Fort Collins, CO 80524 AUTHORIZED REPRESENTATIVE ACORD 25 (2016103) ©1988-2016 ACORD CORPORATION.. All rights reserved. The ACORD name and logo are registered marks of ACORD