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HomeMy WebLinkAboutTHE GREEK CONNECTION INC DBA TONY'S RESTAURANT & L - INSURANCE CERTIFICATEr® ,a` oRoCERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11/7/2017 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 CON NAME: Chloe Patrick Squires Insurance Solutions LLC q FAX PHONE 970 377-0638 970 377-2370 A/C, No, Ext : ( (A/C, No): ADDRESS: Solutions@Squiresinsurance.net a Member of Affordable American Insurance INSURER(S) AFFORDING COVERAGE NAIC # 2629 Redwing Rd., Suite 150 INSURER A: Clear Blue Specialty Insurance Company Fort Collins CO 80526 INSURED INSURER B : Commercial - Pinnacol INSURER C : The Greek Connection Inc. INSURER D : DBA Tony's Restaurant & Lounge INSURER E : 224 South College Avenue INSURER F Fort Collins CO 80524 COVERAGES CERTIFICATE NUMBER: 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. LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Liquor Liability Y A F05-0000003 1 -00 10/01/2017 10/01/2018 EACH OCCURRENCE $ 1,000,000 PREMISES (Ea occurrence) $ 100,000 X MED EXP (Any one person) $ X Assault & Battery PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY ECT a LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS -COMP/OP AGG $ 2,000,000 Liquor Liability $ 1,000,000 A AUTOMOBILE LIABILITY ANY AUTO ED SCHEDULED ONLY AUOWNTOS AUTOS HIRED NON -OWNED AUTOS ONLY FXAUTOS ONLY AE05-00000031-00 I O 1 /2017 10/01/2018 (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ X (Per accident) $ UMBRELLA LIAB EXCESS LIAR OCCUR EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DED I I RETENTION $ $ BOFFICER/MEMBER WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE EXCLUDED? ❑ Mandatory in NH) If yes, describe under ESCRIPTION OF OPERATIONS below N/A 4104151 05/01/2017 05/01/2018 - STATUTE ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 E.L. DISEASE - POLICYLIMI F $ 500.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder is listed as Additional Insured on the policy as per policy forms and conditions. City of Fort Colllins Risk Managment Dept. 215 N. Mason St. Fort Collins, CO 80524 LhG1911111311111 Wt11lL4113 01 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 5a,,Ar-a, L. Nobt, © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD