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Home My WebLink About622 S COLLEGE AVE - INSURANCE - 3/22/201003/22/2010 12:08 19702040:R05 STANSFIELD INSURANCE PAGE 01 CERTIFICATE OF LIABILITY INSU-RJ NCE DATE(MMODVYYY) a312211 PRooucs.R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Stansfield Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 911E S Col!ege Ave, Suite B HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fort CALTER THE COVERAGE AFFORDED BY THE POLICIESFOw •BE_••• ollins, CO 80525 ph-970-204-0020 fx-970-204-0305 INSURED Los Tarascos Inc 622 S College Ave Ft. Collins, CO 80524 INSURERS AFFORDING COVERAGE NAIC # PR 9 201p INSURER Farmers Insurance Exchange — INSURER D__..__.—.____—._.....--__.___ ' '--- INSURER D: . THE POLICIES OF INSURANCE LISTED BELOW I LAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THEPOLICY PERIOD INDICATED, NOT ANY (REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR Of HER DOCUMENT WITH WITHSTANDING RGSPEf.:T TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL (I IE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR DD' POLICY EFFECTIVE POLICY EXPIRATION POLICY NUMBER fWNDJ . -DA7Ea�nrYn LIMBS A TGENERALY 60471295302/07/2010 02/07/2011 F.ACH OCCURRENCE __ $1,000,000 GENERAL LIABILITY TbTMAGE YSFFENFEO --�_PREM13E'(ELt�wr0$100,000 MADE I"- OCCUR MED s ComplOps orm Pr=11 ONALR ADV INJURY _ $ 1,000,000 PER: OM081LE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS AGE LIABILITY ANY AUTO ESS I UMBRELLA LIABILITY OCCUR n CLAIMS MADE DEDUCTIBLE A IWORKERS COMPENSATION A041 AND EMPLOYERS' LIABILITY YIN ANY PROPRIF.TOR/PARTNER/EXECUTIVE ncR�rco n.Icp,pgq EXCLUDED? (Mandarory In NH) Fy If yes, describe under SPECIAL PROVISIONS below OTHER Restaurant I OF OPERATIONS / LOCATIONS /VEHICLES area is also covered un( "'A I Ir W M I C nULU ,it;' ^f port Collins 'ax# 970-498-7986 GENCRAL COMBINED SINGLE LIMIT $ (Eia r�cddnnl) BODILY INJURY ..._...,- BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ _(Per acddent) -EA ACCIDENT $ �., EA ACC $ (DENT $i EA EMPLOYEE(( 81 nal insured. SHOULD ANY OF THE ABOVE DESCRIFIED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30--- DAYS WRITTEN NOTICE TO THE CERTIFICAIE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR C. Los Tafrascos 970-416-88455 I ' CORD 25 (2009/01) 1088.2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are regisferec! markr. of Af,;ORD 03/22/2010 15:22 197020403''- STANSFIELD INSURANCE PAGE 01 ,aco CERTIFICATE OF LIABILITY' INSURANCE °"¢`""�°""Y" PRoouccR THIS CERTIFICATE. IS ISSUED AS A MATTER OF INFORMATION Stansfield Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 5135 S College Ave, Suite B HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Fort Collins, CO 80525 ALTER THE COVERAGE AFFORDED -BY THE POLICIES BELOW. ph-970-204-0020 fx-970-204-0305 INSURERS AFFORDING COVERAGE —----... --...— - -- -- -- — --------------=— INSURED INSURER A; NAIC #Farmers Insurance Exchange Los Tarascos Inc 67.2 5 College Ave - INSURER B: ------------ ------ — ----—_--_-- INSURER C Ft. Collins, CO 80524 - --- -- - - -- ------ ----- IN,SURFR D: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO 711- INSURF,.D NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMI' 14T WITH Rf:;PE•;T TO WHICH THIS CERTIFICA"rE 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIL) CLAIMS. NSR DO' POLICY NUMBER POLICY EFFECTIVE I _POLICY E:YPIRATION -T11MwM y l UgTFJ/1tMQ LIMITS A GENERAL LIABILITY 804712953 02/07/2010 02/07/;t011 —' X EACH OCCURRENCE _ f 1,�00,��0 COMMERCIAL. GENERAL LIABILITY �_`TO RE-1 El, - aak!�' (Ea-nurronceL s 100,000 CLAIMS MADE � OCCUR - � —------. - I r roducts Comp/Ops MED[xPoneLorao,) $5,000road Form PERSONAL A. ADV INJURY $1,000,000 — GEN'L AGGREGGAAT�E LIMIT APPLIES PER: POLICY X I PF O LOC AUTOMOBILE LIABILITY A; IY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS AGE LIABILITY ANY AUTO 'SSI UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE A IWORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/i nccrcoMq,pFR EXCLUDE[ (Mandatory In NMI If es, describe under SPECIAL PROVISIONS below OTHER Restaurant IESCRIPTIO?I OF OPERATIONS lutsid� area is A04107894 YIN 1TKc? COMBINED SINGLE. LIMIT (F:a nccldentl $ ❑ODILYINJURY (Par PraSun) .. .. ....5.. ..._...., -..,, BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ AUTO ONLY_E_A ACCIDENT $ 011'IER THAN ,. EAACC $ —_ AUTO ONLY. AGG $ 02/07/2010 02/07/2011 EACH OCCURRENCE I$ under policy #604712953 R City of FtcCell ns is named as additional insured. S "r4l.Alt IYVLOER Collins CANCELLATION ax# 970-498-7986 TAORIZ OFTHE ADOVE DrSr.RIDEO POLIC IE S DE CANCELLED BEFORE THE EXPIRATION OF, T14E LSSUING INSURER WILT. ENDEAVOR TO MAIL `30--- _, DAYS WRITTEN HE CERTIFICAIC HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL OBLIGATION OR IJABIIJTY OF: ANY KIND UPON THE INSURER, ITS AGENTS OR A1iVF:S�_ _ LOS TajraSCO$ 9]0-418-88455 EPRESENTATIVE Jam' n 1rJ88-20U RD CORPORATION. All rights reserved. The ACORD name and logo are registered mark, of ACORD Apr 15 08 07:27p RoV ')ins Family Insurance 870 °93-4181 p.2 U ACORD CERTIFICATE OF LIABILITY INSURANCE _I 4;1172 07 PRODUCER (303) 799-8112 rAX: (303) 765-9016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The Ahbe Group P HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 7108 S Alton Way ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Building E Centennial CO 80112-2112 INSURERS AFFORDING COVERAGE NAICN msunru INsuRCRNTravelers Insurance LOS TARASCOS INS(IRFRR. MEXICAN RESTAURANT NSIUEac: 626 S College INSURER D: _._—_....._..._—. FORT COLLINS CO 80526 INSURER L: _.._. "OVERAGES TIME POLICIES OF INSURANCE USIEU 8ELOW HAVE 8EEN ISSUED I IHE INSUHEU NAM EU ABOVE FOR THE POLICY PERIOD INOICATEO. NOTWITHSTANDING ANY REOUIRLMLNT, TERM OR CONDITION OF ANY CONTRACT OR OTHot DOCUMENT WITH RCSPLCT TO WHICH THIS CLRTIHCATIMAY RF ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DCSCR101=D HEREIN 13 SUBJECT TO ALL THE TERMS, FXCLUGION5 AND CONDITION: OF SUCH POLICIES. AG �..Fr' 1[�'.MAYHAVE. RFEH QUCFDgY..PAIO CLAIMS. ..._ _. --- '--. - -- INSR ADD'L TYPE CF INSURANCE POLICY NUMBER DATE NIP.VFOWYVL PDATE MMMIODDNyµ LIMIYR 000, OO( LIADIUTV .CACLLOf.C.URRCNCF. rOENERAL GENERAL LLIBILITY UAMAGL TO NLN 1'I:U PREMI"YES(Ea OCCVreRC01 E 300, 00( A fCOMMERCIAL I )CLAIMSM )F. I%'OCCUR 61300960M772 2�7/2008 2�7/2009 W.DEXP(Anymnpnw E 5,00( PC " N LAU%t INJURY E 1,000,000 __ EIiALAGGRFCnTC a 2,000,000 I GCNL AGGREGATE LIMIT APPLIES PER . PROOUCT5-.C9MQPAUG, 1 2, 000, COD X POLICY IC f LOC AUTOMOBILE UADIURY COMHINhU SINGLE. LININ S iANY AUTO (Ea w,ci,WMl .. . _..... .. ALLOVACDAUIO'' DODILYINJURY E SCHEOULEDAUTOS (Vaf pawn) HIHEV AU TUB HLR)ILY INJURY = NON -OWNED AUTOS (Par Aaytlanll PROPFRTYnAMAGP E (Pa aCcido ) CARACE LIABILITY AUTO ONLY -17A ACCIDENT E _ ANY AUTO OTHER THAN . A'A(;.r,, .1 ... AUTO ONLY. S i I EXCCSSNMBRELLA LIA1OILf1Y ... I OCCUR CLAIMS MADE j/��/ ��j,(/�/; AOOnCOATr S ! N n IN/Yv DEDUCTIBLE ' V 7 TFNf N 1 15 X WONKF.R$COMPPNSATION AND Q� U� wC tiTAT I- niH- A j /� I TORY UMIyS I ENPLOVERLIABILITY CEACH ACCIDFNI S 1001000 _ ANY HItOPI(d <tl IUIWAtiINCIULX[f.11TNC 11 �� Ii L OFFK:CP/MCMOLN CXCLUU[U'r �O —.'q V —n_ 1 2009 1:I rA:rw - PA rmVyOYF.F.E 100, 000 If yaa, derma unp r ' 1 SPECIALHI VISIONS 1 r.LL,000 NS� _F-POI1"IIMIT E 500 A OTHER property 60 — 109 aYainoaa P aanal Proporty Limit; $63,60C D.CUCtlbLo: $500 DESCRIPTION OF OPERATONSILOCATIONSNENN:I Certificate holder is listed as CERTIFICATE HOLDER City Of Fort Collins) Fort Collina, CO W ACORD 25 (2001108) INS025 (UIW)).Wa win regards to the General C.iability. l`� OVE DESCRIBED POLICIES OF. CANCELLED BEFORE THE U �C U OF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL lITICE TO THE CERTFICATE POLDER NAMED TO THE LEFT, BUT (IMPOSE NO OGUGAYION OR UABILITY OF ANY KIND UPON THE RlPRlE[NTATIVE1y. I _ _ ' O vACORD CORPORATION 7800 I Popo 1 of 7 02/23/2011 13:58 19702040305 STANSFIELD INSURANCE PAGE 01 ACORU �. CERTIFICATE OF LIABILITY DATC IMMoomwl INSURANCE 02/23/2011 PRODUCER Stanfield Insurance Agency 5125 S College Ave, Suite B 9 Fort Collins, CO 80525 ph-970-204-0020 fx-970-204-0305 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Los Tarascos Inc 622 S College Ave Ft Collins, CO 80524 INSURER A: Farmers Insurance Exchange INSURER8: INSURER a: INSURER D: INSURER e: --- (:UVhKAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT. OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMIT$ SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. n+.:R LMRM nDD TYPE or INS POLICY NUMBER PO ICY EFLK"CEFFWTIV6 PoucYPw'IRATIDN DATE IMMOBAYM LIMITS A GENERAL LNBIUTY 604712953 02/07/2010 02/07/2011 EACH OCCURRENCE $1,000,000 X _COMMERCIAL GENERAL LIABILITY . 02/07/2011 02/07/2012 FS E Ire a _ $100,000 CLAIM; MADE Q OCCUR ! ED EXP (Arry onePerson) $6,000 X Products Comp/Ops PERSONAL $ ADV INJURY $1 000 000 road Form GENERAL AGGREGATE $2 OOO,OOO GENL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGO $2r000,000` POLICY X PRO-JrCT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ee eCCIdenl) BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per peroon) $ HIRED AUTOS _ BODILY INJURY NON -OWNED AUTOS IPer eoeldenl) $ PROPERTY DAMAGE $ (Per ocLldenl) GARAGE LIABILITY AUTO ONLY -EA ACCIDENT $ OTHER THAN FA ACC $ --T- ANY AUTO . $ AUTO ONLY: AGO EXCESS / UMBRELLA LIABILITY BACH OCCURRENCE $ AGGREGATE _ $ OCCUR CLAIMS MACE $ DEoucnBLE1-'--- - RETENTION $ f A ANOEMPLOYERS• LIABILITY WORKERS COMPENSATION A NO A04107894 02107/2010 02/0712011 Y '^'C sTATU• orN- OF;ANY PROPRIETORIEXCLUDRIEXECUTVE YON OFFICEPJMEMBH) EXCLUDED? 02/07/2011 02/07120,12 E.L. EACH ACCIDENT S100,000 r (Mandatory In and It yae, dnerlE¢ under E.I. DISEASE -EA EMPLOYE 3100 000 r EL DISEASE - POLICY LIMIT $500,000 S• ECIAL PROVISIONS Oetdw q orneRBusineas property $163,80 604712953 02107/2010 02/07/2011 Building S 618,000, 02/07/2011 02/07/2012 )Butside Pationarrea Is also under policy #604712953 A City of Ft Collins le named as additional insured. ]FRTIFICnTFunlnco __._____ __ _ amity of Fort Collins 281 N College Ave :ort Collins CO 80522 4ttn Rhonda 3h#970-217.1089 -ax#970-221.6378 SHOULD ANYOFTNE ABOVE DESCRIBED POUCIESBE CANCELLEDBEFORE THE" RATION DATE THEREOF, THE HUNG INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTMCATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY HIND UPON THE INSURER, ITS AGENTS OR REPMAENTATNr: 25 The ACORD name and logo are registered marks of ACORD All rights reserved.