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HomeMy WebLinkAbout302 S COLLEGE AVE SUITE 130 - Filed P-PERMITS -Otyof �� Coll ___ lns _______ -1:P�,a�nn�,n�gl!,., !!,D�ev�e�fo�p�m!!!en�t�&�T�ra!!!n�see o�rt�a�tl�on , � _ , Engineering Department Revocable Perm it forPortable Sign in the Right-of-W ay(min mum of 7 days required for epproval) Permit Number: L.ps ___ _ Approval Date: Applicant Name: __ A_m_a __ n..:..:da=-=Li.:.:.:m:=a ______ Phone: _9:..;7..:0..::.58.;..1_4_1_99 __ _ Compan y or Business name: Lima Coffee Roasters__ __;::::.:.:.::..::.::.:..:.��::..:.:.::.:...:..-------- Bu siness Address of Sign location: 302 S College Ave Suite 130 City, Stale, Zi p: Fort Collins, CO 80524 Company Address if Different than Sign Address: ______________ _ City, Slate, Zip: _______________________ _ Applicant agrees to submit with this permit ap plication a minimum 8.5x11 Inch dimensional drawing tha t Illustrates the location of the pr oposed po rtable sign, obstructlon(s), or other structure or amenities In the public right-of-way. This permit is non-transferable, is personal to the Applicant and is non-assignable. Applicant agrees that any transfer or ownership of the entity holding the permit will terminate this permit and require a new application to be flied by the new owner. Applicant has read this permit and agrees to abide by the current City of Fort Collins Municipal Codes, Standard Specifications and any such special conditions, restrictions, and re gulations that may be imposed by the City Engineer. Applicant's Signaturemtle: -•��-00.105'1] Date: 1 / 11 / fj Conditions: _________________________ _ Last Revised 2/09 281 No/th College Avenue, P.O. Box 580 ,Fort Collins, CO 80522-0580 ,970.221.6605 ,FAX 970.221.6378 WWW .fcg ov .com/engineering ____23-15003 1/17/2023 INDEMNITY AGREEME1''T FOR PORTABLE SIGN PERMIT . The Pem1ittee hereby covenants that it will indemnify and hold the Le ssor hannless from 011 clai.ms, demands, judgments, costs, and expenses, including nttomey's fees, arisin g out of anya�ctdent o� oc.currencc causing injury to any person or property whomsoever or whatsoever due direc�y or md1rectly to the issuan ce of t he portable sign permit and the placement and us_e of the penmtted portable sign by the Permittee and, its agents and employees, unless such accident_ or ?ccurrcnce results from any tortuous misconduct or negligent act or omiss ion on the part of the City, its agents and employee s. Dated this ____:.1 .;._l _ day of J Cll1 vrllt1J , £025 . Pennittee Name: J'.l.ma..ruid_Uma By: Title: Q\l)Of X Address of Portable Sign: � CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DD/YYYY) 05/18/2021 THIS CERTIFICATE IS ISSUED ASA MATT£R OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON lltE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER TME COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING tNSURER(S), AUTMORIZED REPRESENTATIVE OR PRODUCER,ANDlliE CERTIFICATE HOlDER. IMPORTANT: If the c.rtllk:ate holdw 11 an ADDITIONAL INSURED, the pollcy(lel) must have ADDmONAL INSURED provl1lon1 or be endoraecl. If SUBROGATION IS WAIVED, aubject to the term• and condition• of the policy, certain polldes may 19qulrean endorsement. A statement on thll certlftcate dou not confer rights tothecertltlc:ate holder In leu ol 111dl endor,ement(a). PRODUCER Benjamin Morgan(0708316) 2726 Illinois Dr Apt 202 Fort Collins co 80525-3689 INSURED LIMA COFFEE ROASTERS LLC 302 S COLLEGE AVE STE 130 FORT COLLINS co 80524 COVERAGES CERTIFICATE NUMBER: CONTACT NAME: PHONE (A/C, NO, EXT); 970-4 72-1002 I FAX (A/C,NO): 888-775-1596 E-MAIL ADDRESS: bmorgan1@farmersagenl.com INSURER(S)AFFORDING COVERAGE INSURERA: Truck Insurance Exchange INSURER 8: Farmers Insurance Exchange INSURERC: Mid Century Insurance Company INSURER 0: INSURER E: INSURERF: REVISION NUMBER: NAIC# 21709 21652 21687 THIS IS TO CERTIFY THATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME ABOVE FOR THE POLICY PERIOD INDICATED. NOlWITHSTANOING 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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CIAIMS. INSR TYPE OF INSURANCE ADDTL SUBR POLICY NUMBER POLICYEFF POUCYEXP LIMITS LTR INSD WVD (MM/DD/YYYY) (MM/DD/YYYY) � COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 D CLAIMS-M ADE I X I OCCUR DAMAGE TO RENTED $ PREMISES(Ea Occurrence) 75,000 MED EXP (Any one person) $ 5 00( A y N 607204743 05/17/2021 05/17/2022 PERSONAL&ADVINJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 4 000 00{ Fl POLICY □ PROJECT □ lOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE UMIT $ 2,000,000 {Ea accident) ANY AUTO BODILY INJURY (Per person) $ - A OWNED AUTOS SCHEDULED BODILY INJURY (Per accident) $ ONLY AUTOS N 607204743 05/17/2021 05/17/2022 -HIREO AUTOS X NON-OWNED PROPERTY DAMAGE $ ONLY AUTOS ONLY {Per accident) >-s UMBRELIAUAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION s s WORKERS COMPENSATION I PER I I OTHER $ AND EMPLOYERS' UABIUTY STATUTE ANY PROPRIETOR/PARTNER/ Y/N E.l. EACH ACOOENT EXECUTIVE OFFICER/MEMBER C N/A EXCLUDEO?{M•nd•tory In NH) E.l. DISEASE-EA EMPLOYEE If yes. d1!$cribe under DESCRIPTION OF E.l. DISEASE-POLICY LIMIT s OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES �CORD 101, AddllloMI Rem•rka Schedule, may be attached If more space la required) Location(s): 302 S College Ave, Fort Collins, C 80524 Endorsement -(IF APPLICABLE, WILL BE DELIVERED WITH POLICY). CERTIFICATE HOLDER CANCELLATION CA PROPERTY OWNER FORT COLLINS, LLC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEUED BEFORE THE EXPIRATION a Delaware limited liability company DATI: THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 130 EAST ST f"" ··�-- ACORD 25 (2016/03) 31-1769 11-15 AUTMORIZED REPRESENTATIVE Benjamin S Morgan II "'""'" ©1988-201 SACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD --L- D ::::i D< c.., L OD £ n� j� t .l::. l =sCT .::e � .,.=· 1f ,..,� �$l t � -,...a�� la:. 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