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HomeMy WebLinkAboutBIKE BAR TOURS LLC DBA FORT COLLINS BIKE BAR - INSURANCE CERTIFICATE_tc'cI R CERTIFICATE OF LIABILITY INSURANCE DATE(M M/D D/YYYY) r4111/2017 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 If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. this certificate does not confer rights to the certificate holder in lieu of such endorsements . or be endorsed. A statement on PRODUCER Nielsen Insurance Agency 12587 SW 68th Ave Tigard, OR 97223 CONT ""ACT Taira Stronach NAME: PHONE (503) 684-6598 nX N. (503) 244-6881 E-MAIL taira@niagency.com INSURERS AFFORDING COVERAGE NAIC# INSURER A: MaXum Indemnity Co. INSURED Bike Bar Tours LLC dba Fort Collins Bike Bar 13496 22nd Place Golden, CO 80233 INSURER B: INSURER D: INSURER : INSURER F: rn\/FRAr.FR CFRTIFIftATF NI IMRFR- RFVLSInN Ni iMRFR. 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. L IN TYPE OF INSURANCE INSD WVD P LI YN M R POLICY EFF MM D/YYYY POLICY EXP M Y Y LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1 000,000 CLAIMS -MADE M OCCUR PR MI rr n $ NO 000 MEDEXP (Anyoneperson) $ 1,000 A Y BDG0062176-06 03/21/1703/21/18 I PERSONAL &ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 qPOLICY PEA LOC PRODUCTS - COMP/OPAGG $ 2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT aacANYAUTO $ BODILY INJURY (Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE P r i n $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY UMBRELLA LIAB HCLAIMS-MADE OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS LIAB ED RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y N PER OTH- TATIT77 I ER ANY PRO PRI ETORIPART NER/EXECUTIVE OFFICER/MEMBER EXCLUDED? NIA E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS belowE.L. DISEASE - POLICY IMIT DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101. Additional Remarks Schedule, may be attachedif more space is required) Certificate holder is named as Additional Insured. CFRTIFI('.ATF Hnl r)FR CANr.F1 I ATII City of Fort Collins 215 North Mason Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Fort Collins,O 80524 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN r ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE L © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD