HomeMy WebLinkAboutTHE SANDTRAP INC DBA MACKENZIES PUB AND GRILL - INSURANCE CERTIFICATEDATE
ACOR ,. CERTIFICATE OF -LIABILITY INSURANCE 01/02/2010YYV)
01 /02/2010
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
FIRST MAINSTREET INS LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE',
DOES NOT AMED,
PO BOX 847 MAR 2 2010 AOTDR THE COVERAGER. THISIEIAFFORDED BY THE POLICIESXBELOW R
LONGMONT, CO 805025510
(888) 661-3938
SV654 882 INSURERS AFFORDING COVERAGE NAIC #
INSURE SANDTRAP INC. _ INSURER A:THE PHOENIX INSURANCE COMPANY
THEDBA MACKENZIE'S PUB & GRILL I URER B:
5750 SOUTH LEMAY INSURER C:
FT. COLLINS, CO 80525 FE 6 2 MNSUREFI D:
I INSURER E:
C(VFRA(;FC
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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR
ADD'
POLICY EFFECTIVE
POLICY EXPIRATION
LTR
INSR
TYPE OF INSURANCE
POLICY NUMBER
DATE (MM/DDNY)
DATE (MM/DDNY)
LIMITS
A
X
GENERAL LIABIITY
680-753G3525-10
01 /01 /2010
01 /01 /201 1
EACH OCCURRENCE
$ 1 000 000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE � OCCUR
DAMAGE TO RENTED
PREMISES Ea occurrence
$ 300,000
VIED EXP (Any oneperson)
$ 5,000
PERSONAL & ADV INJURY
$ 1 ,000,000
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OP AGG
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRO-
X POLICY[71 JECT I
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
(Ea accident)
$
ANY AUTO
ALL OWNED AUTOS
BODILY INJURY
(Per person)
$
SCHEDULED AUTOS
HIRED AUTOS
BODILY INJURY
NON -OWNED AUTOS
(Per accident)
$
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
OTHER THAN EA ACC
$
ANY AUTO
$
AUTO ONLY: AGG
EXCESS/UMBRELLA LIABILITY
EACH OCCURRENCE
$
OCCUR CLAIMS MADE
AGGREGATE
$
S
$
DEDUCTIBLE
RETENTION $
$
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
WC STATU- 0 H
TORY LIMITS ER
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. DISEASE - EA EMPLOYEE
$
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
AS RESPECTS TO GENERAL LIABILITY, CERTIFICATE HOLDER IS ADDITIONAL INSURED -
MANAGERS OR LESSORS OF PREMISES CG 20 11 FOR THE FOLLOWING LOCATION
5750 SOUTH LEMAY, FORT COLLINS, CO 80525
r-n I Ir(wly I r MUL.Urn I;ANlL;tLL/4 I IIJN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF FORT COLLINS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
GOLF DIVISION
PO BOX 580 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL
FORT COLLINS, CO 80522 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR
REPRESENTATIVES. 41
AUTHORIZED REPRESENTATIVE
ACORD