HomeMy WebLinkAboutSapphire Events LLC - Insurance Certificate 2024-2025 FOUNDERS INSURANCE COMPANY'"'
A MULTIPLE LINE STOCK COMPANY
1350 EAST TOUHY AVENUE,SUITE 200W,DES PLAINES,ILLINOIS 60018-3303
(800)972-8778 LIQUOR LIABILITY
AMENDED DECLARATION
AGENCY ACCT
Finance Company - Add EFFECTIVE 11/19/2024
POLICY NUMBER FROM POLICY PERIOD TO
2023009596 11/19/2024 11/19/2025 12: 01 AM STANDARD TIME 3709
NAMED INSURED AND ADDRESS PRODUCER
SAPPHIRE EVENTS LLC DBA SAPPHIRE EVENTS VIRTUS UNDERWRITING GROUP, LLC
1050 EAST COUNTY ROAD #76 10106 W SAN JUAN WAY #100
WELLINGTON, CO 80549 LITTLETON, CO 80127
(303) 904-3777
THE NAMED INSURED IS SAPPHIRE EVENTS LLC DBA SAPPHIRE EVENTS
COVERAGES
THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS/POLICIES FOR WHICH A PREMIUM IS
INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
COVERAGE PART/POLICY ATTACHED PREMIUM
COMMERCIAL LIQUOR LIABILITY COVERAGE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $6, 308.00
MINIMUM AND DEPOSIT PREMIUM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $6,308.00
THE CHANGE OF THIS POLICY HAS RESULTED IN AN
ADDITIONAL PREMIUM OF . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $0.00
FORMS THAT APPLY TO APPLICABLE COVERAGE PARTS
ENDORSEMENT NO EDITION DATE DESCRIPTION
FIC-PN 07-15 PRIVACY NOTICE
CG 21 70 01-15 CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM
IL 09 85 12-20 DISCLOSURE PURSUANT TO TERRORISM RISK INSURANCE ACT
LLCAN 04-16 CANCELLATION ENDORSEMENT
CO-CSL 01-11 COLORADO LIQUOR LIABILITY COVERAGE PART
16E-0006 07-21 VIRUS OR BACTERIA EXCLUSION
16E-0026 04-22 EXCLUSION - FIREARMS
ADDITIONAL INSUREDS)
AI# INTEREST NAME AND ADDRESS
1 PROPERTY OWNER OR CITY OF FORT COLLINS
LESSOR(S)
P 0 BOX 580
FORT COLLINS, CO 80522
2 PROPERTY OWNER OR CITY OF FORT COLLINS
LESSOR(S)
417 W MAGNOLIA ST
FORT COLLINS, CO 80522
W W W.FOUNDERSINSURANCE.COM 01/0 3/2 0 2 5
FOUNDERS INSURANCE COMPANY'"'
A MULTIPLE LINE STOCK COMPANY
1350 EAST TOUHY AVENUE, SUITE 200W,DES PLAINES,ILLINOIS 60018-3303
(800)972-8778 LIQUOR LIABILITY
AMENDED DECLARATION
AGENCY ACCT
Finance Company - Add EFFECTIVE 11/19/2024
POLICY NUMBER FROM POLICY PERIOD TO
2023009596 11/19/2024 11/19/2025 12 : 01 AM STANDARD TIME 3709
NAMED INSURED AND ADDRESS PRODUCER
SAPPHIRE EVENTS LLC DBA SAPPHIRE EVENTS VIRTUS UNDERWRITING GROUP, LLC
1050 EAST COUNTY ROAD #76 10106 W SAN JUAN WAY #100
WELLINGTON, CO 80549 LITTLETON, CO 80127
(303) 904-3777
LIQUOR LICENSE CITY OF FORT COLLINS
ASSIGNEES)
PO BOX 580
FORT COLLINS, CO 80522
FINANCE COMPANY(S)
FC# NAME AND ADDRESS
4 FIRST INSURANCE FUNDING
450 SKOKIE BLVD, STE 1000
NORTHBROOK, IL 60062
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THE COVERAGE PARTS/
POLICIES ATTACHED, WE AGREE WITH YOU TO PROVIDE THE INSURANCE DESCRIBED THEREIN.
W W W.FOUNDERSINSURANCE.COM 01/0 3/2 02 5
FOUNDERS INSURANCE COMPANY'""
A MULTIPLE LINE STOCK COMPANY
1350 EAST TOUHY AVENUE, SUITE 200W,DES PLAINES,ILLINOIS 60018-3303
(800)972-8778 LIQUOR LIABILITY
AMENDED DECLARATION
AGENCY ACCT EFFECTIVE 11/19/2024
POLICY NUMBER FROM POLICY PERIOD TO
2023009596 11/19/2024 11/19/2025 12 : 01 AM STANDARD TIME 3709
NAMED INSURED AND ADDRESS PRODUCER
SAPPHIRE EVENTS LLC DBA SAPPHIRE EVENTS VIRTUS UNDERWRITING GROUP, LLC
1050 EAST COUNTY ROAD #76 10106 W SAN JUAN WAY #100
WELLINGTON, CO 80549 LITTLETON, CO 80127
(303) 904-3777
I
i
LOCATION ADDRESS (ES)
LOCATION 1 LOCATION 2
417 W MAGNOLIA 408 MASON COURT
FORT COLLINS, CO 80521 FORT COLLINS, CO 80524
LOCATION 3
2145 CENTER AVENUE
FORT COLLINS, CO 80526
COVERAGES
LOC ITEM TERR CLASS DED AMT EXPOSURE PREMIUM
1 1 104 4447 174, 616 2, 358.00
2 1 104 4447 69, 907 2, 414 .00
3 1 104 4447 2,228 437.00
COVERAGE PER PERSON OCCURRENCE AGGREGATE
COMBINED SINGLE LIMIT $1, 000, 000 $2, 000, 000
ADDITIONAL FORMS AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART ONLY
ENDORSEMENT EDITION DESCRIPTION LOC ITEM LIMIT PREMIUM
NO DATE
CO 20 26 07-04 ADDITIONAL INSURED-DESIGNATED PERSON OR 1 1 100.00
ORGANIZATION
LL01 04-16 ASSAULT AND/OR BATTERY COVERAGE BUY-BACK 1 1 100, 000 362.00
16E-0003 02-21 EXCLUSION-UNDERAGE PERSONS, EMPLOYEES, 1 1
CONTRACTORS, SUBCONTRACTORS, DANCERS AND
ENTERTAINERS
CO 20 26 07-04 ADDITIONAL INSURED-DESIGNATED PERSON OR 2 1 100.00
ORGANIZATION
LL01 04-16 ASSAULT AND/OR BATTERY COVERAGE BUY-BACK 2 1 100, 000 371.00
16E-0003 02-21 EXCLUSION-UNDERAGE PERSONS, EMPLOYEES, 2 1
CONTRACTORS, SUBCONTRACTORS, DANCERS AND
ENTERTAINERS
CO 20 26 07-04
WWW.FOUNDERSINSURANCE.COM 01/03/2025
DDITIONAL INSURED-DESIGNATED PERSON OR 3 1 100.00
ORGANIZATION
LL01 04-16 ASSAULT AND/OR BATTERY COVERAGE BUY-BACK 3 1 100, 000 66.00
16E-0003 02-21 EXCLUSION-UNDERAGE PERSONS, EMPLOYEES, 3 1
CONTRACTORS, SUBCONTRACTORS, DANCERS AND
ENTERTAINERS
MINIMUM AND DEPOSIT PREMIUM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $6, 308.00
WWW.FOUNDERSINSURANCE.COM 01/03/202 5