HomeMy WebLinkAboutTHE ICE CREAM WAGON INC - INSURANCE CERTIFICATE,a�oizo® CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
3/31/17
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 Allied Specialty Insurance, Inc
10451 Gulf Blvd
Treasure Island, FL 33706
8002373355
CONTACT
NAME:
PHONE FAX
Ext: AIC No:
E-MAIL
L
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC f
INSURERA: T.H.E. Insurance Company
12866
INSURED The Ice Cream Wagon, Inc.
6801 Colorado Blvd
INSURER8:
Commerce City CO 80022
INSURERC:
INSURER D :
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER: RFVISIC)N NUMRFR-
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.
INPOLICY
TR
TYPE OF INSURANCE
ADDL
SUBR
POLICY NUMBER
MMIDD/YPOLICY EFF
EXP
MMIDD/YYYYI
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
CLAIMS -MADE OCCUR
CPP0100761-07
04/O1/17
04/O1/18
DAMAGE
REMSES EaoccTurence
$ 50,000
MED EXP (Any one person)
$
PERSONAL & ADV INJURY
$ 1,000,006
GEN'L
AGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICY PRO ❑
JECT LOC
HOTHER:
PRODUCTS - COMPlOP AGG
$ 1,000,000
$
A
AUTOMOBILE
LIABILITY
ANY AUTO
CPP0100761-07
04/01/17
04/01/18
COMBINED SINGLE LIMIT
LEa accident
$ 750,000
BODILY INJURY (Per person)
$
OWNED X SCHEDULED
AUTOS ONLY AUTOS
_
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPER DAMAGE
-
$
$
UMBRELLALIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I J RETENTION $
$
WORKERS COMPENSATION
OTH-
I
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
N/A
SPER
TATUTE ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, maybe attached if more space is required)
*********************PROOF OF INSURANCE ***************************
I.CR I trtt-K I c rtLJLUGR
CITY OF FT COLLINS
RISK MANAGEMENT
PO BOX 580
FT COLLINS, CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD