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HomeMy WebLinkAbout159994 ODELL BREWING - INSURANCE CERTIFICATE (9)ACC)R oDATE (MM/DD/YYVY) ® CERTIFICATE OF LIABILITY INSURANCE F6/1/2017 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 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 CONTA NAME: CT Dana Stewart, CIC, CISR Flood and Peterson CPA/ HCExoNE : (970)266-7149 No:(970)506-6845 PO Box 578 ADDRESS.DStewart@floodpeterson.com INSURER(SI AFFORDING COVERAGE NAIC t Greeley CO 80632 INSURERA:Charter O INSURED INSURER B :Travelers Odell Brewing Company INSURER C:FarmiA to 800 E. Lincoln Avenue INSURERD: 25615 41483 Fort Collins CO 80524 I INSURERF: I I COVERAGES CERTIFICATE NUMBER:GL/AU/XS/WC x6/2018 REVISION NUMRER- 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 A DL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS -MADE X I OCCUR $ 000 DAMAGE TO RENTED PREMISES PREMISES Ea occurrence MED EXp (Any one person) 630-2H193508-COF-17 6/1/2017 6/1/2018 $ 10,000 PERSONAL & ADV INJURY $ 11000, 000 GENERAL AGGREGATE GENT AGGREGATE LIMIT APPLIES PER: $ 2,000,000 POLICY JECTT E LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 11000,000 X BODILY INJURY (Per person) $ A ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS 810-2H193508-COF-17 6/1/2017 6/1/2018 BODILY INJURY (Per accident) $ X PROPERTY DAMAGE Per accident NON -OWNED HIRED AUTOS X AUTOS $ X UMBRELLA UAB X OCCUR EACH OCCURRENCE $ 10, 000, 000 AGGREGATE $ 10, 000, 000 B EXCESS UAB CLAIMS -MADE DED I X RETENTION $ CUP-214193508-TIL-17 6/1/2017 6/1/2018 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A UB-2H649541-AFC-17 6/1/2017 6/1/2018 X PER , STATUTE ER _ E.L. EACH ACCIDENT $ 11000,000 E.L.DISEASE - EA EMPLOY $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Event: Small Batch Revival - May 27, 2017 The City of Fort Collins, its officers, agents, employees and volunteers are included as Additional Insured as required by written contract with respects to liability arising out of the above referenced event. GtH I Ir1UA I t HULUtH GANGtLLA I IUN City of Fort Collins Risk Management P.O. Box 580 Fort Collins, CO 80522-0580 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 D Stewart, CIC, CISR/ © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD N S025 (201401)