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HomeMy WebLinkAboutCOOKIE MIKE LLC - INSURANCE CERTIFICATE (6)COOKIA OP ID: P5 ACORO �,� CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYVY) 10/05/2015 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 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 NAME: House Account __ _ Brown 8, Brown Inc AX 4532 Boardwalk Dr, Suite 200 A/CCN o Ext:970-482-7747 (A/CC,No): 970-484-4165 Fort Collins, CO 80525 E-MAIL House Account ADDRESS: INSURED Cookie Mike, LLC 123 N College Ave #106 Fort Collins, CO 80524-2489 INSURER(S) AFFORDING COVERAGE NAIC S INSURER A: Continental Casualty Company 20443 INSURER B : Travelers Indemnity Company 125658 INSURER E : INSURER F : COVFRAGFS CERTIFICATE NUMBFR- 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 DD POLICY EFF POLICY EXP LIMITS LTR N POLICY NUMBER MM/DD/YYYY MMIDD/YYYY A COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE FIOCCUIR B4024288877 1111712015 11117/2016 DAMAGE TO RFNTE9__ PREMISES Ea occurrence $ 300,000 X MED EXP (Any one person) $ 10,000 Business Owners PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PROJECT LOC PRODUCTS - COMP/OP AGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ BODILY INJURY (Per person) _ $ ANY AUTO ALLOWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ NON -OWNED HIRED AUTOS AUTOS _ UMBRELLA LIAB OCCUR I EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE EXCESS LIAB $ DED RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTIVE Y / N INUB9C23934915 03/01/2015 03/0112016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 100,00 OFFICER/MEMBER EXCLUDED? N/A ❑ (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 100,000 If Indescribe under DESGRI PTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 PROPERTY 220,81 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached H mcre space Is req~ rFRTIFIr`ATF I r)FR rAN(:FI I ATIrIN CITYFC2 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. PO Box 580 AUTHORIZED REPRESENTATIVE Fort Collins, CO 80524 House Account ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD