The information contained herein is to describe the contractual requirements that Bimbo Bakeries USA has indicated to myCOI. These contractual requirements should NOT be used to provide inaccurate information regarding current insurance policies. Questions regarding interpretation of this document can be directed to our support team at 317-759-9426.

INSURED

TPS TOP SHELF DISTRIBUTION CORPORATION 1234 MAIN ST NOWHERE, IN 46219

CARRIER REQUIREMENTS

POLICY LINE

POLICY LIMITS

GENERAL LIABILITY

EACH OCCURRENCE

$

1,000,000

CLAIMS MADE

DAMAGE TO RENTED PREMISES (Ea occurrence)

$

X

OCCUR

MED EXP (Any one person)

$

5,000

PERSONAL & ADV INJURY

$

GENERAL AGGREGATE

$

1,000,000

GEN'L AGGREGATE LIMIT APPLIES PER

PRODUCTS - COMP/OP AGG

$

POLICY

PROJECT

LOCATION

$

AUTO LIABILITY

COMBINED SINGLE LIMIT (Ea accident)

$

1,000,000

X

ANY AUTO

BODILY INJURY (Per person)

$

ALL OWNED AUTOS

BODILY INJURY (Per accident)

$

SCHEDULED AUTOS

PROPERTY DAMAGE (Per accident)

$

HIRED AUTOS

NON-OWNED AUTOS

UMBRELLA /EXCESS LIABILITY

OCCUR

EACH OCCURRENCE

$

Claims Made

AGGREGATE

$

WORKERS COMP /EMPLOYEE LIABILITY

WC STATUTORY LIMITS

OTHER

E.L. EACH ACCIDENT

$

E.L. DISEASE - EA EMPLOYEE

$

E.L. DISEASE - POLICY LIMIT

$

Property

Property Causes of Loss

Deductibles

Building

$

Basic

Building

Personal Property

$

Broad

Contents

Business Income

$

Special

Extra Expense

$

Earthquake

Rental Value

$

Wind

Blanket Building

$

Flood

Blanket Pers Prop

$

Blanket BLDG & PP

$

$

$

Boiler and Machine

Boiler & Machinery /Equipment Break Down

$

$

Certificate Holder

Bimbo Foods Bakeries Distribution, LLC and its affiliates C/O: myCOI P.O. Box# 501970, 8710 Bash Street Indianapolis, IN 46256

ADDITIONAL REQUIREMENTS

Division Name: IBP: T-Z.
- Contract ID: Vehicle Vin(s): # 3.

General Liability

- Umbrella or Excess Liability may be used to meet policy limits.
- CERTIFICATE HOLDER ADDRESS MUST BE LISTED IN THE CERTIFICATE HOLDER BOX AS FOLLOWS: 5525 N. MacArthur Blvd., Suite 850, Irving, TX 75038
- Please confirm on the certificate or by uploading endorsement(s) that Additional Insured applies to this policy.
- Additional Insured Names: Bimbo Foods Bakeries Distribution, LLC and its affiliates, and their officers, directors, and employees,
- Additional Insured applies to General Liability.

Automobile Liability

- Umbrella or Excess Liability may be used to meet policy limits.
- CERTIFICATE HOLDER ADDRESS MUST BE LISTED IN THE CERTIFICATE HOLDER BOX AS FOLLOWS: 5525 N. MacArthur Blvd., Suite 850, Irving, TX 75038
- If there is more than one vehicle under this policy, please list VIN numbers in the description of operations box on the certificate of insurance.
- Please confirm on the certificate or by uploading endorsement(s) that Additional Insured applies to this policy.
- Additional Insured Names: Bimbo Foods Bakeries Distribution, LLC and its affiliates, and their officers, directors, and employees,
- Additional Insured applies to Automobile.

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