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HomeMy WebLinkAboutCRAFTWORKS RESTAURANTS & BREWERIES INC - INSURANCE CERTIFICATE (5)ACORD, CERTIFICATE OF LIABILITY INSURANCE 6/1/2018 F DATE(MM/DD/YYYY) 1 5/31/2017 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 CONT CT NAME: A/C, FAX No, Ex[): A/C, No 8110 E. Union Avenue Suite 700 Denver CO 80237 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC # (303) 414-6000 INSURER A : Starr Indemnity & Liability Company 38318 INSURED Craftworks Restaurants & Breweries, Inc. INSURER B : Liberty Mutual Fire Insurance Company 23035 1379094 201 West Main Street, Suite 301 Chattanooga, TN 37408 INSURER C : Liberty Insurance Co oration 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 LT R TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF MM/DD/YYYY POLICY EXP (MMIDDrCYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR SIR $250.000 N N 1000305162171 6/1/2017 6/1/2018 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence SOO OOO X MED EXP (Any oneperson) XXXXXXX PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER. POLICY JE LOC OTHER GENERAL AGGREGATE $ 10,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 1 $ B AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED ONLY AUTOS HIED AUTOS ONLY X AUUTOS ONLY N N AS2651290343027 6/1/2017 6/1/2018 CND LIMIT $ 11000,000 X BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY (Per accident $ XXXXXXXAUTOS X PeO-OWEPROr Pccdenil DAMAGE $ XXXXXXX $XXXXXXX C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE N N TH7651290343117 6/1/2017 6/1/2018 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I RETENTION $ $ XXXXXXX L C WORKERS COMPENSATIONPER AND EMPLOYERS' LIABILITY Y / N AN OFFICERIMEMBER/EXCLUDED7 ECUTIVE I (Mandatory in NH) if Dyes, describe under ESCRIPTION OF OPERATIONS below N / A N WA765D290343057 (AOS) WC7651290343017 (WI) 6/1/2017 6/1 /2017 6/1/2018 6/1/201 g X STATUTE ER E.L. EACH ACCIDENT $ 1 000 000 E.L. DISEASE - EA EMPLOYEE 1,000,000 E.L. DISEASE - POLICY LIMIT 1 OOO OOO A A Liquor Liability N N 1000305162171 Continuous until Cancelled 6/1/2017 6/1/2018 $1,000,000 each Occurrence $2,000,000 Aggregate $250,000 SIR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: Old Chicago 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 Additional Insured as respects General Liability per written contract. CERTIFICATE HOLDER CANCELLA I IUN gee Rltacnment 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 C ACORD 25/2016/031 ©1 8 2015 ACORD CORPO ATION. All rights reserved The ACORD name and logo are registered marks of ACORD Craftworks Named Insureds Schedule Craftworks Restaurants & Breweries, Inc. Craftworks Restaurants & Breweries, LLC CraftWorks Restaurants & Breweries Group, Inc. GB Holdings, Inc. GB Parent, Inc. Gordon Biersch Brewery Restaurant Group, Inc. GB Acquisition, Inc. Big River Breweries, Inc. GB Maryland, Inc. GBBR Texas, Inc. GB Franchise, LLC GB Kansas, LLC Harbor East Brewery, LLC Old Chicago Oregon, LLC Wadsworth Old Chicago, Inc. Old Chicago Franchising, LLC Rock Bottom Arizona, Inc. Walnut Brewery, Inc. Old Chicago of Colorado, Inc. Rockies Trademark, LLC Old Chicago Parker Crossing, Inc. Rock Bottom of Minneapolis, Inc. Old Chicago of Kansas, Inc. Brew Moon Colorado, Inc. Rock Bottom Restaurants, Inc. Old Chicago Westminster, Inc. CraftWorks Foundation, Inc. Miscellaneous Attachment: M498051 Master ID: 1379094, Certificate ID: 12964762