The URL can be used to link to this page

Home My WebLink AboutSMOKING BROS BARBECUE LLC - INSURANCE CERTIFICATE 2020OS-31-10247515-2 Shelter Mptual Insurance Company 1817 W Broadway Columbia, MO G5218 � 1-800-SHELTER (743-5837) e ***MANUAL DEC*** General Liability Insurance Policy Dec�aratioas Named Insured: SMOKING BROS BARBECUE LLC Policy Number: 05-3 i-10247515-2 3703 SALIDA CT Effective Date: 03/04/2020 (08:48 A.M. CST) EVANS CO 80620-2808 Expiration Date: 08/07/2020 {12;O1 A.M. CST) Notice to the Mortgagee/Loss Payee/Addl Insured: Your interest will be continuous until cancellation notice is mailed to you. These Declarations are part of your policy and replace all prior Declarations. Business of the Named Insured: CONCESSIONS FOOD TRUCK Agent: POTTS INS AGENCY LLC OS-E239- I 0 3b10 35TH AVE UNiT 10 EVANS CO 80620 974-356-8282 The Named InsWred is a(n): Corporation Aadit Period: Annually Limits ot Insurance General Aggregate (Other Than Products Compleked Operations) Products Cornpleted Operations Aggregate Limit (See Each Classification Below) Personal And Advertising Injury Limit Each Occurrence Limit Rented To You Limit Medical Expense Limit Descripfion of Hazards $Z,aoa,000 sz,oaa,000 $ i,000,000 $1,40Q,000 $ i 00,000 Any Qne Premises $5,000 Any One Person prem#um Bases Rates Advance {Anqualj Preinium � --- .._.._.. _._. ...._. PREMISES & OPERATIONS- �� 16902 RESTAURANTS — WITH NO SALE QF ALCOHOLIC GROSS SALES PR $1000 2.318 $139A0 BEVERAGES — WITHOUT SEATING $60,000 jTEM ZIP CODE: 80620 3703 SALIDA CT EVANS CO PRODUCTS — COMPLETED OFEIZATIONS 16902 RESTAURANTS -�� WITH NO SALE OF ALCOHOLIC GROSS SALES PR $1000 .178 $11.00 BEV�RAGES - � WITHOUT SEATING $b0,000 ITEM ZIP CODE: 80620 3703 SALIDA CT _ ___ EVANS CO __ �Premium A�,�ustip� �pdorsemen�s � Pollution Liability Coverage Additional [nsured — Vendors CITY OF FORT COLLIIVS Additional Insured — Vendors FT EVENTS LLC Additional Insured — Cancessionaries Trading Under Your Name THE YARD Limits Deductible I�umber Prem�um .. . . _. v. -�---- _.._ $100,000 G-146-G $15.00 C'�'�I CG 20 15 04 13 $15.00 CG 20 15 04 13 $15.00 CG 20 03 04 13 $15.00 Page 1 OS-31-10247515-2 Total for Term (This is Not a Bill): $210.00 Policy forms aud additio�esl endorsements sttached to this policy . Number . _..__. �� . Commercial Generai Liability Co�erage Form CG QO O1 0�4 l3 � Products/compieted Operations Hazard Redefined ~� CG 24 07 4� 9C+ Nuclear Energy Liability Exclusion Endorseme�t {Broad Form} IL 00 21 09 08 Colorado Changes — Cancellation and Nonrenewal IL 02 28 b9 07 Excf Damage to Wark by Subcontr on Your Behalf CG 22 94 10 O1 � Common Palicy Conditions � IL 00 17 11 98 Asbestos Exclusion B-559-B Lead Poisoning Exclusion Endorsement Y L B-601-B Non-Binding Arbitration CG 24 Ol 12 04 Employment-related Practices Exclusion � CG 2l 47 12 07 � Mutual Policy Notification T 5-18-5 Exciusion-Access or Disclosure of [nformation CG 21 47 OS 14 Amendarory Endarsement G-252.1-G Colorado Changes-Civil Union iL 01 49 06 15 Exclusion-Unmanned Aircraft CG 21 09 06 15 Fungi or Bacteria �xclusion CG 21 67 i 2 04 mm� �iddl Insure�i . - . - . THB YARD 3520 11TH AVE EVANS CO 80b20 Addl Insured CITY OF FORT COLLTNS 2I5 N MASON ST FORT COLLINS CO 80524-4402 (�'or Office Use Only) Transaction: P.C. H. O. CODE: 214.00 Policy ID: 42006078524 Po�icy Term; One Year Date Issued: 03-04-2020 'd302202Q' ;�+iddl insured FT EVENTS LLC 5620 KENDALL COURT ARVADA CO 80002-2736 G-2.10-G End af Dec�aratioas � �7`H Page 2 OS-31-10247515-2 SheEter Mutual Insurance Company 1817 W Broadway Columbia, MO 65218 � 1-80Q-SHELTER (743-5837) ***MANUAL DEC*** Generai Liability Insurance Policy Declarations Named Insured: SMOKING BROS BARBECUE Li,C Policy Number: OS-3 1-102475 1 5-2 3703 SALIDA CT Effective Date: 03/02/2020 (12:18 P.M. CST) EVANS CO 80620-2808 Expiration Date: 08/07/2020 (12:01 A.M. CST) Agent: POTTS iNS AGENCY INC OS-E239-10 3fi14 357H AVE UNIT 10 EVANS CO 80620 970-356-8282 Notice to the Mortgagee/Loss Payee�Addl Insured: Your interest will be continuous until cancellation notice is mailed to you. These Dectarations are part of your policy and replace all �rior Declarations. Business of the Named I�sured: CONCESSIONS FOOD TitUCK The Named Insured is a(n}; Corparation Audit Period: Annually Limits of Insurance General Aggregate (Other Than E'roducts Completed Operations) Products — Completed Operations Aggregate Limit (See Each Classification Below) Personal And Advertising injury Limit Each Occurrence Limit Rented To You Limit Medical Expense Limit Dcscription of Hazar�s PREMISES & OPERATIONS- 16902 RESTAURANTS WITH NO SALE OF ALCOHOLIC BEVERAGES -- WITHOUT SEATING ITEM ZIP CODE: 80b20 3703 SALIDA CT �VANS CO _ PRODUCTS COMP[,ETED OPERATIONS — 16902 RESTAURANT5 — WITH NO SALE OF A�.COHOLIC BEVERAGES — WITHOUT SEATING ITEM ZIP CODE: 80620 3703 SALIDA CT �VANS CO $2,000,000 $2,U00,000 $1,004,000 s r ,000,000 $140,000 Any Qne Prerr�ises $5,000 Any One Person Yremium Bases ltafes A�"dvance (Ann�alj Premium GROSS SALES PR $1000 2.318 $139.00 $G0,000 GROSS SALES PR $1000 .178 $ I 1.44 $b0,000 �Prem�um A�3ustin� Endorsements timits . Deductiblc �Iumber �re�nium - - --�--. ...,. - -•��-�---�-� � � -- --�- -�-� .__ .. . ........ ....-- —� Popution Liability Goverage $100,000 G-146-G $15.00 Additional Insured — Vendors CG 20 15 04 13 $15.00 CITY OF FORT COLLINS _ Additional Insured Vendors CG 20 15 04 13 $15.00 FT EVENTS LLC Total For Term (This is Not a Bill): $195.00 (=�'H Page 1 OS-31-102A7515-2 Policy forms and addlE'iodal endors.ements atfached to #bis pol�cy ,;�� ;�- l�umber � -� -- --� -�— - �;- - �� Commercial General Liability Co�erage Form CG 00 O l 04 13 Productslcompleted Operations Hazards Redefined � CG 24 07 O1 96 N�clear Energy Liability Exc�usion Endorsement (Broad Form) IL 40 2l 09 08 Cotorado Changes — Cancellation and Nonre�ewal IL 02 28 09 07 Bxcl Damage to Work by Subcantr on Your Behalf CG 22 9�4 10 O l Fungi or Bacteria Exclusion �� CG 21 67 12 04 Common Policy Conditions IL OQ 17 1 i 98 � Asbestos Exclusions B-559-B Lead Aoisoning Exclusion Endorsement �-501-B Non-Binding Arbitration CG 24 O1 I2 04 i Employment-related Practices Exclusion V f� CG 21 47 12 07 Mutual Policy Notification 5-18-5 � Exclusion-Access or Disciosure of Information CG 21 07 OS 14 Amendatory Endorsement G-252.1-G Calorado Changes — Civil Union IL O l 25 11 13 Exclusion-Unmanned Aircraft CG 2! 09 06 15 Addl Insured FT EVENTS LLC 5620 KENDALi. COURT ARVADA CO 80002-273b (For Office Use Only) Transaction: P.C. H. O. CODE: 195.00 Policy ID: 42006078524 Palicy Term: One Year G-2.10-G Date Issued: 03-�4-2020 '03042020' AddlInsured CITY OF FORT COLLINS 215 N MASON ST FORT COLLINS CO 8Q524-4402 Ead of Declarations � ��I C Page 2 A1lstnte Lrer+holder Service Cente� PO 8ox 660349 Aaflas, TX 75Z6b-0349 �f��l'lI��I'��I�II�I�II��RII�'I��I'�'ll'llfllf�l�l"��I"Il�I�� CITY OF FORT COLLINS PO BOX 580 FORT COLLINS CO 80522-0580 Certificate of Insu�rance Effecti�e date of certificate; May 6, 2020 Page 1 of 2 Policyholder: DANIEL PEER, BETHANY PEER 339 CHAPEt HlLL DR BRIGHTON CO 80601-4717 policy number 976 $79 880 Allstate Insurance Company Narthbrook, Illinois, certifies that the following insurance is in force: Policy period: Beginning May 5, 2020 through No�ember 6� 2020 at 12:01 a.m. standard time The person or organixation designated below is described in t�e policy as: CITY OF FORT COLLIN5 ❑ Lienholder Agent: PO BOX 5$4 (�ass Payable Clause) DINO DICAREO FORT COLLINS, CO 80522-0580 � Additio�al Interested Party (303) 828-33$6 Co�erages designated below are afforded for each descri6ed �ehicle: ltem V1N [�imit o f liabil�ty 2003 UNE 486TE10243A462804 BI Each Person • Collision • Comprehensive Pb �ach �ccurrence See reverse side for provi5ion5 toncerning Loss Payable Clause and Addrtio�af Interested Party. This Certificate ot lnsuranre neither a f firmatively nor negatively amends, extends or alters the coverage a jforded by the pofrcy referred to above. Date: 43/27/20 � .•: Aeduttible $0 � Certificate of Insurance Allstate lnsurance Compan Policy number. 976 879 880 The Loss Payable Clause of such policy pro�ides: Page 2 of 2 "7he company reserves the right to cancel such policy at any tirrte as pro�ided by its terms, but in such case the company shall notify the Lienholder when not fess than ten days thereafter such cancellation shall be effective as to the interest of said L�enholder therein and the company shaEl have the right, on like notice, to cancel this agreement." The Additional In#erest Endorsement of such polity, in part, provides: "...such insurance as is afforded by the policy" far automobile [iability insurance listed on the reverse side hereof applies also to the person or orga�ization named as Additional Interested Party. "As respects such...interest, no cancelEation...and no endorsement...adversely affecting such acfditional interest, shall be effective until ten (9p) days followir�g the mailing of written notice (to the person or organizaiion) of such cancellation o� endarsement..." M 0 a O m O f�. fl m n o o�