HomeMy WebLinkAboutSMOKING BROS BARBECUE LLC - INSURANCE CERTIFICATE05-31-10247515-2
Shelter Mutual Insurance Company ***MANUAL DEC***
1817 W Broadway
Columbia, MO 65218
1-800-SHELTER (743-5837)
General Liability Insurance Policy Declarations
Named Insured:
SMOKING BROS BARBECUE LLC Policy.Number. 05-31-10247515-2
3703 SALIDA CT Effective Date: 03/04/2020 (08:48 A.M. CST)
EVANS CO 80620-2808 Expiration Date: 08/07/2020 (12:01 A.M. CST)
Agent: POTTS INS AGENCY LLC
05-E239-10
3610 35TH AVE
UNIT 10
EVANS CO 80620
Notice to the Mortgagee/Loss Payee/Addl Insured: Your interest 970-356-8282
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 The Named Insured is n(n): Corporation
Audit Period: Annually
F. General Aggregate (Other Than Products — Completed Operations) $2,000,000
Products— Completed Operations Aggregate Limit (See Each Classification Below) $2,000,000
Personal And Advertising Injury Limit $1,000,000
Each Occurrence Limit $1,000,000
Rented To You Limit $100,000 Any One Premises
Medical Expense Limit $5,000 Any One Person
PREMISES & OPERATIONS-
16902 RESTAURANTS — WITH NO SALE OF ALCOHOLIC
GROSS SALES PR $1000 2.318
$139.00
BEVERAGES — WITHOUT SEATING
$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
Premium d usting Endorsements' _ _
Limit D ucti�e "' `- . um e r a , P cmtum
Pollution Liability Coverage $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
Additional Insured — Concessionaries Trading Under Your
CG 20 03 04 13
$15.00
Name
THE YARD
CTH Page 1
05-31-10247515-2
Total for Term (This is Not a Bill):
Policy. forms.andad it,onal a dorseWho attached to this policy •- Number
Commercial General Liability Coverage Form CG 00 0104 13
Products/comnleted Oaerations Hazard Redefined CG 24 07 0196
Colorado Changes — Cancellation and Nonrenewal IL 02 28 09 07
Excl Damage to Work by Subcontr on Your Behalf CG 22 94 10 01
Common Policy Conditions IL 00 17 1198
B-601-B
Employment -related Practices Exclusion CG 2147 12 07
Mutual Policy Notification S-18-5
Exclusion -Access or Disclosure of Information CG 2107 05 14
Amendatory Endorsement G-252.1-G
$210.00
Colorado Changes -Civil Union
IL 0109 06 15
Exclusion,Unmanned Aircraft
CG 2109 06 15
Fungi or Bacteria Exclusion
CG 2167 12 04
ddl Insured .'. _'
ddl'Insured
THE YARD
FT EVENTS LLC
3520 11TH AVE
5620 KENDALL COURT
EVANS CO 80620
ARVADA CO 80002-2736
`ddlInsured `. -•
CITY OF FORT COLLINS
215 N MASON ST
FORT COLLINS CO 80524-4462
(For Office Use Only)
Transaction: P.C.
H. O. CODE: 210.00
Policy ID`. 42006078524
Policy Term: One Year
Date Issued: 03-04-2020
'03022020'
G-2.10-G
End of Declarations
CTH Page 2