HomeMy WebLinkAboutSMOKIN BROS BARBECUE LLC - INSURANCE CERTIFICATEShelter Mutual Insurance Company
1817 W Broadway
Columbia, MO 65218
1-800-SHELTER (743-5837) o
Named Insured:
SMOKIN BROS BARBECUE LLC
3703 SALIDA CT
EVANS CO 80620-2808
General Liability Insurance Policy Declarations
Addl. Interest or Addl. Insured Copy
Policy Number: 05-31-10247515-2
Effective Date: 04-07-2020 (01:45 PM CST)
Expiration Date: 08-07-2020 (12:01 AM CST)
Agent: POTTS INSURANCE AGENCY INC
05-OE239-10
3610 35TH AVE
UNIT 10
EVANS CO 80620
970-356-8282
Notice to the Additional Insured: Your interest will be continuous until cancellation notice is mailed to you.
Policy and Endorsements are available upon request
Business of the Named Insured: CONCESSIONS FOOD TRUCK
General Aggregate (Other Than Products - 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
PREMISES & OPERATIONS-
16902 RESTAURANTS - WITH NO SALE OF ALCOHOLIC
BEVERAGES - WITHOUT SEATING
The Named Insured is a(n): Corporation
Audit Period: Annually
$2,000,000
$1,000,000
$1,000,000
$100,000 Any One Premises
$5,000 Any One Person
GROSS SALES PR $1000 2.318 $139.00
$60,000
ITEM ZIP CODE: 80620
3703 SALIDA CT EVANS CO
PRODUCTS - COMPLETED OPERATIONS-
16902 RESTAURANTS - WITH NO SALE OF ALCOHOLIC GROSS SALES PR $1000 .178 $11.00
BEVERAGES - WITHOUT SEATING $60,000
ITEM ZIP CODE: 80620
3703 SALIDA CT EVANS CO
Additional Insured- Vendors CG.20 15 04 13 $15.00
CITY OF FORT COLLINS
Additional Insured - Vendors CG20 15 04 13 $15.00
FT EVENTS LLC
Total for Term (This is Not a Bill): $195.00
Page 1
Commercial General Liability Coverage Form CG 00 0104 13
Products/completed Operations Hazard Redefined CG 24 07 0196
Nuclear Energy Liability Exclusion Endorsement (Broad Form) IL 00 21 09 08
and Nonrenewal
Asbestos Exclusion
B-559-B
Lead Poisoning Exclusion Endorsement
B-601 -B
Non -Binding Arbitration
CG 24 01 12 04
Employment -related Practices Exclusion
CG 2147 12 07
Mutual Policy Notification
S-18-S
.Exclusion -Access or Disclosure of Information CG 2107 05 14
Amendatory Endorsement
G-252. 1 -G
Colorado Changes -Civil Union
IL 0 12511 13
Exclusion -Unmanned Aircraft
CG 2109 06 15
CITY OF FORT COLLINS
(For Office Use Only)
Transaction: P.C.
H. O. CODE: 195.00
Policy ID: 42006078524
Policy Term: One Year
Date Issued: 04-07-2020
'0304.2020'
Ad011usur
FT EVENTS LLC
G-2.10-G
.. .. . .. . .. . ..
End: of Dkhif&i6hs:% X . ..... ..
Page 2