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HomeMy WebLinkAboutTHE GREEK CONNECTION INC DBA TONY'S RESTAURANT - INSURANCE CERTIFICATEA X>R" CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 12/8/2016 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 CUNIACI NAME: Brenda Stewart Squires Insurance Solutions LLC q FAX PHONE 970 377-0638 ( ) (970) 377-2370 AIC No Ext : ) A/C, No ADDRESS: bstewart(&insuranccaai.com a Member of Affordable American Insurance INSURER(S) AFFORDING COVERAGE NAIC # 2629 Redwing Road, Suite 150 Fort Collins CO 80526 INSURER A: Clear Blue Specialty Insurance Company INSURED INSURER B : Commercial - PIM8C01 The Greek Connection Inc. INSURER C : DBA Tony's Restaurant & Lounge INSURER D : 224 South College Avenue INSURER E : Fort Collins CO 80524 INSURER F : 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. INSR LTR TYPE OF INSURANCE INSD NIVD POLICY NUMBER (MWDD/YYYY) (MM/DD/YYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE OCCUR PREMISES (Ea occurrence) $ 100,000 X MED EXP (Any one person) $ Liquor Liability X Assault & Battery PERSONAL & ADV INJURY $ 1,000,000 A Y AI05-00000031-00 10/01 /2016 10/01 /2017 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ❑ PE ' IF -^'I LOC PRODUCTS - COMP/OP AGG $ 2,000,000 OTHER Liquor Liability $ 1,000,000 AUTOMOBILE LIABILITY (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS AE05-0000003 1 -00 10/01/2016 10/01/2017 BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY H AUTOS ONLY X (Per accident) $ UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB DED I I RETENTION $ $ B WORKERS COMPENSATION ND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE FFICER/MEMBEREXCLUDED? El N/A 4104151 05/01/2016 05/01/2017 - STATUTE I ER E.L. EACH ACCIDENT $ 500,000 E.L. DISEASE - EA EMPLOYEE $ 500,000 Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I 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 90524 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 So -Ara, (_. Nob,, ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD