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HomeMy WebLinkAboutCRAFTWORKS RESTAURANTS & BREWERIES INC - INSURANCE CERTIFICATE (4)AcoRij" CERTIFICATE OF LIABILITY INSURANCE 111%� 6/1/2019 F DATE(MM/DD/YYYY) 1 5/23/2018 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 have ADDITIONAL INSURED provisions or 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 E: A/C No Ext : A/C No): E-MAIL ADDRESS: INSURER AFFORDING COVERAGE NAIC # (303) 414-6000 INSURERA: Starr Indemnity & Liability Company 38318 INSURED Craftworks Restaurants & Breweries, Inc. 1379094 201 West Main Street, Suite 301 Chattanooga, TN 37408 INSURER B : Liberty Mutual Fire Insurance Company 23035 INSURER C : Liberty Insurance Corporation 42404 -INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 12964762 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 SUER WVD POLICY NUMBER POLICY EFF 1MMIQDfYYYY POLICY EXP (MM/DDfYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY N N 1000305162181 6/1/2018 6/1/2019 EACH OCCURRENCE 1,000000 CLAIMS -MADE � OCCUR DAMAGE REM PREMISES (ETO a occur ence 1,000,000 X MED EXP (Any oneperson) XXXXXXX SIR $250-000 PERSONAL & ADV INJURY $ 1,000 000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY❑ PE � LOC GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 2,000 000 $ OTHER: g AUTOMOBILE LIABILITY N N AS2651290343028 6/1/2018 6/1/2019 (CO8BINEDtSINGLE LIMIT $ 1,000,000 X BODILY INJURY (Per.person) $ XXXXXXX ANY AUTO OWNEDAUTOS ONLY AUTOSSCHED BODILY BODILY INJURY (Per accident $ XXXXXXX X Perr . d. DAMAGE $ XXXXXXX AUTOS ONLY X AUUTO ONLDY $ XXXXXXX C X UMBRELLA LIAB NCLAIMS-MADE OCCUR N N TH7651290343118 6/1/2018 6/1/2019 EACH OCCURRENCE $ 10 000 000 AGGREGATE $ 10,000,000 EXCESS LIAB DED I I RETENTION $ $ }{]()(X'xxx C C. WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY OFFICER/MEMBER EXCLUDED?ECUTIVE FNI (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N/A N WA765D290343058 (AOS) WC7651290343018(WI) 6/1/2018 6/1/2018 6/1/2019 6/1/2019 X STATUTE GER EL EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE- POLICY LIMIT 1000 000 A A Liquor Liability N N 1000305162181 Continuous until Cancelled 6/1/2018 6/1/2019 $1,000,000 each Occurrence $2,000,000 Aggegate $250,000 SIR DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Old Chica-o of 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 ATditional Insured as respects General Liability per written contract. L.AIYL.CLLA I IVry )CCI%LL'aCrinlent 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 Cityy of Fort Collins 300 LaPorte Ave Fort Collins CO 80521 f ACORD 25 (2016/03) ©1 8 2015 ACORD CORPO A] All rinhte roc m—ri The ACORD name and logo are registered marks of ACORD