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HomeMy WebLinkAboutCRAFTWORKS RESTAURANTS & BREWERIES INC - INSURANCE CERTIFICATE (3)ACORD, CERTIFICATE OF LIABILITY INSURANCE 6/1/2016 DATE(MM/DD/YYYY) 5/28/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies 8110 E. Union Avenue Suite 700 Denver CO 80237 CONTACT NAME: PHONEA/C, No, Est): (AC,No): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A: Libeny Mutual Fire Insurance Company 23035 INSURED CraftworkS Restaurants & Breweries, Inc. INSURER B: Liberty Insurance Co oration 42404 1379094 201 West Main Street, Suite 301 Chattanooga, TN 37408 INSURER C : INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 129641/62 REVISION NUMBER: XXXXXXX THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP MM/DD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY N N EB2651290343035 6/1/2015 6/1/2016 EACH OCCURRENCE 750,000 CLAIMS -MADE OCCUR DAMAGE TO RENTED PREMISES Ea occurrence 75O OOO X MED EXP (Any oneperson) XXXXXXX SIR $250,000 PERSONAL & ADV INJURY $ 750,000 GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 9.750,000 POLICY PRO- F7 JECT LOC PRODUCTS - COMP/OP AGG $ 11750,000 $ OTHER A AUTOMOBILE LIABILITY N N AS2651290343025 6/1/2015 6/1/2016 EOa aBcld DtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXXX ANY AUTO ALLOWNED SCHEDULED AUTOS OS IX INJURY (Per accident XXXXXXX PROPERTY DAMAGE Per accident $ XXXXXXX X HIRED AUTOS AUTOS $XXXXXXX B X UMBRELLA LIAB I }( OCCUR N N 'I'H7651290343115 6/1/2015 6/1/2016 EACH OCCURRENCE $25000000 AGGREGATE $ 25,000,000 EXCESS LIAR CLAIMS -MADE DED I X I RETENTION $ 10,000 $ }{x}(}(xxx B WORKERS COMPENSATION AND EMPLOYERS' LIABILITYY/N N WA765D290343055 AOS 6/1/2015 6/1/2016 PER OTH- X STATUTE FIR B ANVPROPRIETOR/PARTNER/EXECUTIVE � N/A �'C7651290343015 W[ 6/I/2015 6/1/2016 E.L. EACH ACCIDENT $ 1 000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE /� 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT 1 1,000,000 A Liquor Liability N N T02651290341045 6/1/2015 6/1/2016 S1.)00,ou0each Occurrence A Continuous until Cancelled $2,000,000 Aggregate $150,000 Deductible DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Old Chicago ot'Colorado, Inc., d/b/a Old Chicago. 147 S College Ave, Fort Collins, CO 80524. Restaurant and Outdoor Patio. The Certificate Holder is named as Additional Insured as respects General Liability per written contract. GtK I IhIUA I t NULUtK UANGtLL.ATIUN Jee Attachment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12964762 AUTHORIZED REPRESENTATIVE City of Fort Collins 300 LaPorte Ave Fort Collins CO 80521 ll ACORD 25 (2014/01) ©1 B812014 ACORD CORPO ATION. All rights reserved Thn ACr)pn n— ­1 Innn zrn wnictnrnrl m 11— of ACrlptl