HomeMy WebLinkAboutPATRICE HUXLEY DBA PATTY CAKES - CONTRACT - RFP - 7407 DOWNTOWN CONCESSIONAIRESDOWNTOWN CONCESSION AGREEMENT
THIS AGREEMENT is made and entered into this 25th day of July, 2013, by and between THE
CITY OF FORT COLLINS, COLORADO, a Municipal Corporation (City), and Patty Huxley, dba
Patty Cake's (Concessionaire).
WITNESSETH
WHEREAS, the City Council passed Ordinance No. 36, 1994, establishing the Downtown Plan
Area as a concession area for the sale of goods and services from outdoor locations; and
WHEREAS, the City has established various concession locations in the Downtown Plan Area;
and
WHEREAS, the City agrees to grant to the Concessionaire and the Concessionaire accepts
from the City a concession for outdoor vending at:
Site # 10. Public Right -of -Way (ROW), SE corner of Oak and College. For day and night
use.
NOW THEREFORE, in consideration of the mutual covenants and obligations herein
expressed, the parties agree as follows:
Section 1. Contract Documents
The contract documents consist of this Agreement and Exhibits "A" & "B" incorporated herein by
this reference. These form the contract, and are incorporated herein by this reference.
Section 2. Terms of the Agreement
A. This Agreement shall be effective from July 25, 2013, until May 31, 2014, unless sooner
terminated as herein provided. The City may, at its option, renew the Agreement for
additional one (1) year terms, to a maximum of three (3) additional one year terms.
However, either party may terminate this Agreement without cause, by providing written
notice to the other party of its intention to terminate at least thirty (30) days prior to the
end of the then existing term.
B. In the event that the concession location can not be used because of improvements
being made at the concession location, this Agreement may be suspended on 30 days
notice to the Concessionaire. The suspension shall continue until the improvements are
completed or it is determined that the location can no longer be used as a concession
site. The City will use a good faith effort to relocate the concession site if needed.
Section 3. Concession Operations
The City hereby grants Concessionaire a concession for the use of the property described as:
Site #10, Public Right of Way (ROW), SE corner of Oak and College concession area (per
Exhibit A) For day and night use outdoor vending. The Concessionaire shall have the
7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 1 of 10
exclusive right to operate an outdoor vending concession with this area in accordance with the
agreement.
A. Independent Contractor: The services to be performed by the Concessionaire are those
of an independent contractor and not as an employee of the City. The City shall not be
responsible for withholding any portion of Concessionaire's compensation hereunder for
the payment of FICA, Worker's Compensation or otherwise.
B. Records: The Concessionaire shall keep adequate and proper business records of all
expenses and receipts of the concession operations. At the request of the City, all such
business records shall be made open and available for inspection and audit by the City
of Fort Collins Treasury Division.
C. Monetary Provision: The Concessionaire agrees to pay the City an amount equal to
One -Hundred -Twenty -Dollars ($120) per site per year, plus two 2 percent of gross
receipts from the concession operations conducted pursuant to this Agreement. Gross
receipts shall include all revenues, excluding sales tax received by the concessionaire
from concession operations. All such gross receipt payments shall be paid to the City on
the same day that sales and use tax payments are due. However, the payments for the
concessions must be submitted separately. The $120 annual fee is due immediately, in
the initial term, and June 1" any renewal term. Monthly payments shall be paid to the
City Sales Tax Office prior to the 10th of each month for every month the agreement is in
force.
D. Licenses: The Concessionaire shall obtain and pay for all licenses needed for the
operation of the concession including, but not necessarily limited to, a County Health
Department Food Services establishment inspection, City and State sales tax licenses.
Any such licenses held specifically by the Concessionaire in connection with this
Agreement shall be surrendered by the Concessionaire at the time of termination of this
Agreement.
E. Laws, Rules & Regulations: The operation of the concession granted under this
Agreement shall, at all times, conform with all applicable Federal, State, and local laws
and with all applicable rules and regulations adopted by the City or any of its Boards or
Departments.
F. Insurance/ Indemnity: The Concessionaire shall indemnify, save and hold harmless the
City from all claims and losses, including costs and reasonable attorney's fees arising
directly or indirectly out of the Concessionaire's use of the concession area or operation
of the concession. The Concessionaire shall maintain commercial liability insurance in
the amount of $500,000 combined single limits naming the City as an additional insured
under this Agreement of the type and with the limits specified within Exhibit B. The
Concessionaire before commencing services hereunder shall deliver to the City's
Director of Purchasing and Risk Management, P.O. Box 580, Fort Collins, CO 80522,
7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 2 of 10
one (1) copy of a certificate evidencing the insurance coverage required from an
insurance company acceptable to the City.
G. Signage: All signs on the concession cart must be approved by the City. Signs may be
displayed in or on the cart only unless additional signage is approved by City staff.
H. Cart: The Concessionaire will be required to have a mobile cart. The cart may not
exceed the size of four (4) foot wide, ten (10) foot long and eight (8) foot high, excluding
roof overhangs and wheels. The design and appearance of the cart must conform to the
specifications described in Concessionaire's proposal, unless otherwise agreed to in
writing by the parties before the cart may be used at the concession area. The City
reserves the right to approve any modifications, changes, or alternative cart. The cart is
subject to inspection by City. The cart must be maintained and repaired to the City's
satisfaction. The cart must be removed from the right-of-way when not in use.
I. Restrictions: Equipment such as tables, chairs, benches and displays not attached to the
cart may not be used except for items & equipment authorized, in writing, by the City
Representative. Merchandise must be restricted to the cart or appropriate storage
containers if authorized. Vendor area must not exceed 10 X 10 feet, excepting only a
tarp or other protective medium placed to protect underlying surface. Cart must be
located in approved location on site and cannot impede pedestrian flow on the sidewalk.
J. Cleanliness: Concessionaire shall keep the concession area clean of all trash within 100
foot radius of site. Food concessionaires must use a tarp under cart to minimize grease
deposits and pay site cleaning fee. Concessionaire shall pay One -Hundred -Twenty
Dollars ($120.00) per month as their portion of the total cleaning fee for power washing
of the site granted. If concessionaire is at site which is split between day and night
operations with another food and beverage concessionaire, the concessionaire shall pay
portion of above cleaning fee as determined by the City. Cleaning fee subject to change
during term of agreement based on frequency required with at least thirty (30) days
notice to the Concessionaire.
K. Sales Tax Returns: All sales tax returns and concessionaire payments to the City
associated with the concession operation must be filed by their due date. No
assessment fees, penalties or interest will be waived by the City.
L. Power Source: If the Concessionaire needs electrical power the Concessionaire must
provide for such power through the City Light & Power Department at the
Concessionaire's expense. Arrangements to supply power to the concession area must
be reviewed with the appropriate City departments. Portable generators will not be
permitted due to concerns regarding compatibility and noise.
M. Stock: The Concessionaire shall maintain an adequate stock of supplies on hand for all
occasions in order to supply the need of parties desiring to patronize the concession
area.
7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 3 of 10
N. Hours: The Concessionaire must keep the concession area open for business as
directed by the City. Days of operation shall be agreed to by both parties and the
minimum hours of operation must be maintained. Minimum hours are:
11:OOa.m. until 2:OOr).m. on Friday, Saturday, and Sunday (Days).
6:OOP.m. until 1:OOa.m. on Friday and Saturday (Nights)
Concessionaire is not required to operate on national holidays or holidays
recognized by the City where City offices (except for emergency services offices) are
closed.
O. Inclement Weather: The Concessionaire shall not be required to operate the concession
when it is raining, snowing, hailing, and abnormally windy or when the air temperature is
below 50 degrees Fahrenheit.
P. Product. The products authorized are as described in Concessionaire's proposal and
agreed to by the City. The City will not pre -authorize new products but does reserve the
right to review any new products that may be added. This is to ensure that the new
products meet the same quality as those proposed in the original Request for Proposal.
Q. Blackout Dates. Concessionaire will not be allowed to operate in granted site during the
following special events in the downtown area: Colorado Brewers Festival, New West
Fest, and Old Town Car Show. Dates for 2013 are: June 22nd, June 23rd, August 16th,
August 17th, August 18th, and September 7th. Contact the Downtown Business
Association (DBA) at (970) 484-6500 to receive an application for a site at these events,
and event dates for subsequent years of this contract. The DBA will work with
concessionaires regarding the location of the site and a booth rate.
Section 4. General Conditions
A. The Concessionaire shall neither assign any of the rights nor delegate any of the duties
under the provisions of this Agreement without having first obtained the written
permission of the City. The Concessionaire shall not sublet any portion of the
concession area or allow any other person to take possession of any portion of the
concession areas without the written consent of the City.
B. Vacant sites resulting from either no -bid or termination may be filled at anytime for the
duration of the current one (1) year period. Responsible parties will be awarded vacant
sites as acceptable proposals are received. The city may, at its option, renew the
Agreement for the formerly vacant sites for additional one (1) year periods not to exceed
the balance of the additional periods remaining for this Agreement.
C. This Agreement may not be enlarged, modified or altered except in writing, signed by the
parties as an amendment hereto.
7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 4 of 10
D. No waiver of any breach of this Agreement shall be held or construed to be a waiver of
any subsequent breach thereof.
E. It is expressly understood and agreed by and between the parties hereto that in the
performance of the terms and conditions of this Agreement, time is of the essence.
F. The location assigned is not transferable to another vendor or concessionaire.
G. Fixtures and Improvements:
1. The Concessionaire agrees that all auxiliary equipment needed to operate the
Concession shall be installed at its expense. Prior to making any and all
improvements on said premises, the Concessionaire agrees to obtain the approval
of the appropriate City Department and shall supervise the construction of said
improvements.
2. Upon the termination of this Agreement the Concessionaire shall remove any
fixtures or improvements made by it to the concession area. However, the
concession area must be restored to as good a condition as the premises were in
at the time the Concessionaire took possession thereof.
H. This Agreement shall be binding upon and inure to the benefit of the heirs, successors,
and assigns of the parties hereto.
I. If either party must resort to legal action to enforce the terms of this Agreement, the
prevailing party shall be awarded its costs and reasonable attorney's fees.
J. Any notice required or desired to be given under this Agreement will be considered
delivered to the other party upon hand delivery or upon its deposit in the United States
mail, postage prepaid, sent by registered mail, addressed to the other
party at the following address:
City:
City of Fort Collins
Purchasing Division
P.O. Box 580
Fort Collins, CO 80522
Concessionaire:
Patty Huxley
dba Patty Cake's
230 Youngs Gulch
Belivue, CO 80512
K. Notwithstanding the time periods contained herein, either party may terminate this
Agreement at any time without cause by providing written notice of termination to the
other party. Such notice shall be delivered at least fifteen (15) days prior to the
termination date contained in said notice unless otherwise agreed in writing by the
parties. All notices provided under this Agreement shall be effective when mailed,
postage prepaid and sent to the above address.
7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 5 of 10
Section 5. Default
A. The Concessionaire shall be in default under the terms and conditions of this
Agreement, if the Concessionaire fails to cure the default within ten (10) days after
written notice setting forth the nature of the default is delivered to the Concessionaire.
B. In the event the default is not timely cured, the City may elect to (a) terminate this
Agreement and seek damages; (b) treat the Agreement as continuing and require
specific performance or (c) avail itself of any other remedy at law or equity.
Section 6. Prohibition Against Employing Illegal Aliens.
Pursuant to Section 8-17.5-101, C.R.S., et. seq., Service Provider represents and agrees that:
a. As of the date of this Agreement:
1. Service Provider does not knowingly employ or contract with an illegal alien who
will perform work under this Agreement; and
2. Service Provider will participate in either the e-Verify program created in Public
Law 208, 104th Congress, as amended, and expanded in Public Law 156, 108th
Congress, as amended, administered by the United States Department of
Homeland Security (the "e-Verify Program") or the Department Program (the
"Department Program"), an employment verification program established
pursuant to Section 8-17.5-102(5)(c) C.R.S. in order to confirm the employment
eligibility of all newly hired employees to perform work under this Agreement.
b. Service Provider shall not knowingly employ or contract with an illegal alien to perform
work under this Agreement or knowingly enter into a contract with a subcontractor that
knowingly employs or contracts with an illegal alien to perform work under this
Agreement.
c. Service Provider is prohibited from using the e-Verify Program or Department Program
procedures to undertake pre -employment screening of job applicants while this
Agreement is being performed.
d. If Service Provider obtains actual knowledge that a subcontractor performing work under
this Agreement knowingly employs or contracts with an illegal alien, Service Provider
shall:
1. Notify such subcontractor and the City within three days that Service Provider
has actual knowledge that the subcontractor is employing or contracting with an
illegal alien; and
2. Terminate the subcontract with the subcontractor if within three days of receiving
the notice required pursuant to this section the subcontractor does not cease
7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 6 of 10
employing or contracting with the illegal alien; except that Service Provider shall
not terminate the contract with the subcontractor if during such three days the
subcontractor provides information to establish that the subcontractor has not
knowingly employed or contracted with an illegal alien.
e. Service Provider shall comply with any reasonable request by the Colorado Department
of Labor and Employment (the "Department") made in the course of an investigation that
the Department undertakes or is undertaking pursuant to the authority established in
Subsection 8-17.5-102 (5), C.R.S.
f. If Service Provider violates any provision of this Agreement pertaining to the duties
imposed by Subsection 8-17.5-102, C.R.S. the City may terminate this Agreement. If this
Agreement is so terminated, Service Provider shall be liable for actual and consequential
damages to the City arising out of Service Provider's violation of Subsection 8-17.5-102,
C.R.S.
g. The City will notify the Office of the Secretary of State if Service Provider violates this
provision of this Agreement and the City terminates the Agreement for such breach.
Section 7. Special Provisions.
Special provisions or conditions relating to the services to be performed pursuant to this
Agreement are set forth in Exhibit "C" Affidavit Pursuant to C.R.S. 24-76.5-103, consisting of
one (1) page, attached hereto and incorporated herein by this reference. This is for
unincorporated concessionaires.
City:
City of Fort Collins
By:
Gerry S. Paul
Director of Purchasing and Risk Management
Date:
Concessionaire:
Patty Huxley
dba Patty Cake's
sy:
Print Name:
Title: aWh e r
Date: 7l
7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 7 of 10
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7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 8 of 10
EXHIBIT "B"
INSURANCE REQUIREMENTS
1. The Service Provider will provide, from insurance companies acceptable to the City, the
insurance coverage designated hereinafter and pay all costs. Before commencing work
under this bid, the Service Provider shall furnish the City with certificates of insurance
showing the type, amount, class of operations covered, effective dates and date of
expiration of policies, and containing substantially the following statement:
"The insurance evidenced by this Certificate will not be cancelled or materially altered,
except after ten (10) days written notice has been received by the City of Fort Collins."
In case of the breach of any provision of the Insurance Requirements, the City, at its option,
may take out and maintain, at the expense of the Service Provider, such insurance as the
City may deem proper and may deduct the cost of such insurance from any monies which
may be due or become due the Service Provider under this Agreement. The City, its
officers, agents and employees shall be named as additional insureds on the Service
Provider's general liability and automobile liability insurance policies for any claims arising
out of work performed under this Agreement.
2. Insurance coverages shall be as follows:
A. Workers' Compensation & Employer's Liability. The Service Provider shall maintain
during the life of this Agreement for all of the Service Provider's employees engaged in
work performed under this agreement:
1. Workers' Compensation insurance with statutory limits as required by Colorado
law.
2. Employer's Liability insurance with limits of $100,000 per accident, $500,000
disease aggregate, and $100,000 disease each employee.
B. Commercial General & Vehicle Liability. The Service Provider shall maintain during the
life of this Agreement such commercial general liability and automobile liability insurance
as will provide coverage for damage claims of personal injury, including accidental
death, as well as for claims for property damage, which may arise directly or indirectly
from the performance of work under this Agreement. Coverage for property damage
shall be on a "broad form" basis. The amount of insurance for each coverage,
Commercial General and Vehicle, shall not be less than $500,000 combined single limits
for bodily injury and property damage.
In the event any work is performed by a subcontractor, the Service Provider shall be
responsible for any liability directly or indirectly arising out of the work performed under
this Agreement by a subcontractor, which liability is not covered by the subcontractor's
insurance.
7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 9 of 10
EXHIBIT "C"
AFFIDAVIT PURSUANT TO C.R.S. 24-76.5-103
I, t o— 12 , swear or affirm under penalty of
perjury under the laws of the Ste of Colorado that (check one):
I am a United States citizen, or
I am a Permanent Resident of the United States, or
I am lawfully present in the United States pursuant to Federal law.
I understand that this sworn statement is required by law because I have applied for a
public benefit. I understand that state law requires me to provide proof that I am lawfully
present in the United States prior to receipt of this public benefit. I further acknowledge
that making a false, fictitious, or fraudulent statement or representation in this sworn
affidavit is punishable under the criminal laws of Colorado as perjury in the second
degree under Colorado Revised Statute 18-8-503 and it shall constitute a separate
criminal offense each time a public benefit is fraudulently received.
-t2t��� - -)-F i3
Signature Date
7407 Downtown Concession Agreement with Patty Huxley, dba Patty Cake's Page 10 of 10
Q)Allstate.
You're in Rood hands.
ALLSTATE INS
9 7 0 4 8 2 - 2 2 0 0
FAX 970 482-2427
FACSIMILE TRANSMITTAL SHEET
T0: FROM:
David Carey Beth
COMPANY: DATE:
08/09/2013
FAX NUMBER. 10'1'AL NO. OF PAGES INCLUDING COVL'R:
2216707 9
PIIONE NUMBER:
5PNF)FR'C RPTERFNCF NUMRr R:
R[;: YOUR REFL-RP_NCE NUMBER:
Certificate of insurance and dec
pages for auto
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816 5 COLLEGE AVE, FORT COLf,iNS, CO R0526
R2P,53-2
From: GFI FaxMaker To: 19704822427 Page-. 212 Dates 818/2013 1:51:02 PM
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CERTIFICATE OF INSURANCE i'�un um I
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. 'I HIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND ORAL tER THE COVERAGE AFFORDED BY THE POLICIEi4 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 IE. WAIVED,
SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY, CERTAIN POLICIES MAY REQUIRE AN ENDORSEMENT. A STATEMENT (IN THIS
CERTIFICATE DOES NOT CONFER RIGHTS TO THE CERTIFICATE HOLDER IN LIEU OF SUCH ENDORSEMENT(S).
''. PRODUCER INSURER(S) AFFORDING COVERAGE
Northeast Agencies, Inc INSURER A� Essex Insurance Company
6467 Main Street - Suite 104
Williamsville, NY 14221 INSURER BN/A
INSURED INSURER. C�
Patrice Huxley , d/b/a Patty CaKes INSURER D:
230 Youngs GUICh Road
Bellvue, CO 80512 INSURER E: N/A
COVERAGES —
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE Vol: THE
POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCWIENT 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
POLICY
NUMBER
POLICY
EFFECTIVE DATE
POLICY
EXPIRATION DATE
LIMITS
GENERAL LIABILITY
3DH3001
5182013
516f2014
GENERAL AGGREGATE
2.000.000
PRODUCTS-COMIOP ACC.
Included
1.000.000
PERSONALSADV. INJURY
1000.000
EACHOCCURRENCE
100.000
AGE—PREM RENTED TO YOU
5,000
MED EXPENSE (Anyone Parsan)
''.PERSONAL LIABILITY
COMBINDED SINGLE LIMIT
_
MEDICAL PAYMENTS TO OTHERS
''.
EXCESS LIABILITY
EACH OCCURRENCE
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AGGREGATE
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PROPERTY ',,. -__
''. CONTENTS
BUSINESS IN CO ME -
DESCRIPTION OF OPERATIONS I SPECIALTY ITEMS
Store Push Cart
CERTIFICATE HOLDER SHOULD ANY OP THC ABOVE DESORIGlD POLICIES BE CANCELLED
Additiwal Insured•Clty of Fart Collins BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED N
ACCORDANCE WITH THE POLICY PROVISIONS.
Attentiolt Purchasing _
PO Box 580 AUTHORIZED SIGNATURE w�l
Fort Collins, CO 80522
This fax was sent with GFI FA)(maker Pax server. For more information, visit: httpWvAVw.gfLc0m
Allstate.
stateoF4redaClasualty Insurance Company
RENEWAL
Auto
Policy Declarations
Summary
NAMEDINSURED(S)
YOUR ALLSTATE AGENT IS YOUR BILL
Patrice M Huxley
Howell Ins Agency lists your payment options.
and Daniel Baker
(970) 482-2200
230 Youngs Gulch Rd
Bellvue CO B0512-6507
816 S. College Ave
Fort Collins CO 80524
POLICY NUMBER
POLICY PERIOD
9 64 671680 11/11
May 11. 2013 to Nov. 11, 2013 at 12:01 a.m. standard time
VEHICLES COVERED
VEHICLE ID NUMBER LIENHOLDER
1. 02 Honda Accord
JHMC056662CO21517 None
2. 94 Chevy Trk Kt Series
_
2GCEK19K5R1254136 None
3. 04 Chrysler 300M
2C3HE66G24H587397 None
Total Premium
Premium for 02 Honda Accord
$430.55
Premium for 94 Chevy Trk K1 Series
$279.79
Premium for 04 Chrysler 300M
$324.60
Premium for Uninsured Motorists Insurance $78.11
Colorado Theft Prevention Fee
$1.50
TOTAL Premium If you pay In full (Includes
FuIIPay Discount) $1,017.31
TOTAL Premium If you pay In installments $1,114.55
If you pay less than the pay In full amount, you will he charged an Installment feels).
Your Polity fll6ctve Ogre is May 11. 2V13
Your premium reflects the Gold Protection package
Your policy reflects Allstate Preferred Package Savings. We have applied tI1Is savings to your policy because you own a
residential property and insure more than one vehicle.
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Qt4to Ws ualty Insurance Company
Polley Number: 96467168011111 Your Agent: Howell Ing Agency (970)482.2200
Palley Effeellre Date: May 11, 2013
Summary of Discounts - Your total premium includes the following discounts,
which total.- $902.75
Safe Driving Club
$514.41 3 qualified driver(s)
Multiple Policy
$112.33
Responsible Payer
$73.21
Early Signing
$77.76
Homeowner
$65.85
The following discount(s) apply to Vehicle # 1: 2002 Honda Accord
Antiloek Brakes $31,05
The following discount(s) apply to Vehicle S 3: 2004 Chrysler 300M
Antiloek Bmkos $28.14
Driver(s) Listed
Patrice - married, female, age 60
Daniel - married, male, age 61
Maggie - single, female, age 25
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R2853-2
Qst ualty Insurance Company
Polley Number: 9646716801111 Your Agent: Howell Ins Agency (970)482.2200
Polley Effective Dote: May 11. 2013
COVERAGE FOR VEHICLE x 1
2002 Honda Accord
COVERAGE
LIMITS
DEDUCTIBLE
PREMIUM
Automobile Liability Insurance
Not Applicable
$239.77
• Bodily Injury
$50,000 each person
$100,000 each accident
• Property Damage
$100,000 each accident
Auto Collision Insurance
Actual Cash Value
$500
$124.15
(Safe Driving Deductible Reward - doductilble reduction amount available
is $100 )
Auto Comprehensive Insurance
Actual Cash Value
$500
$48.03
Towing and Labor Costs Coverage
$100 each disablement
Not Applicable
$6.40
Rental Reimbursement Coverage
up to $20 per day for
Not Applicable
$12.20
a maximum of 30 days
Total Premium for 02 Honda Accord
$430.55
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tat�oen�a�sualty Insurance Company
Policy Number: 96467158011111 Your Agent: Howell ins Agency (970)482.2200
Policy Effective Date: May 11, 2013
COVERAGE FOR VEHICLE # 2
1994 Chevy Trk K1 Series
COVERAGE LIMITS DEDUCTIBLE
PREMIUM
Automobile Liability Insurance Not Applicable
$135.74
• Bodily Injury $50,000 each person
$100.000 each accident
• Property Damage $100,000 each accident
Auto Collision Insurance Actual Cash Value $500
$62.96
(Safe Driving Deductible Reward - deductible reduction amount available is $100 )
Auto Comprehensive Insurance Actual Cash Value $500
$42.49
Towing and Labor Costs Coverage $100 each disablement Not Applicable
$6-40
Rental Reimbursement Coverage up to $20 per day for Not Applicable
$12.20
a maximum of 30 days
Total Premium for 94 Chevy Trk K1 Series
$279-79
H.l Page 4
W. 1. 2013 M010A9D
R2853-2
Q4t,%q,&ua1ty Insurance Company
Pal Icy Number: 9 64 67168011/11 Your Agent: Howell Ins Agency (970)482.2200
Policy Effective Date: May 11, 2013
COVERAGE FOR VEHICLE k 3
2004 Chrysler 300M
COVEAACE
LIMITS
DEDUCTIBLE
PREMIUM
Automobile Liability Insurance
Not Applicable
$139.61
• Bodily Injury
$50.000 each person
$100,000 each accident
• Property Damage
$100.000 each accident
Auto Collision Insurance
Actual Cash Value
$500
$113.63
(Safe Driving Deductible Reward -
deductible reduction amount available
Is $100 )
Auto Comprehensive Insurance
Actual Cash Value
$500
$52.71
Towing and Labor Costs Coverage
$100 each disablement
Not Applicable
$6.40
Rental Reimbursement Coverage
up to $20 per day for
Not Applicable
$12.20
a maximum of 30 days
Total Premium for 04 Chrysler 300M
$324.60
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R7n53-7
Qfiflatoo,&ualty Insurance Company
Policy Number: 96467168011111 YourAgent: Howelllns AeencY (870)482.2200
Policy Effective Dale: May 11. 2013
Additional Coverage
The following policy coverage is also provided
COVERAGE LIMITS PREMIUM
Uninsured Motorists Insurance $50,000 each person $78.11
for Bodily Injury $100,000 each accident
TOTAL $7&11
Your Policy Documents
Your auto policy consists of this Policy Declarations and the documents listed below. Please keep them together.
- Colorado Auto Policy form AU14512 - Claim Satisfaction Guarantee Endorsement AP4780
- Colorado Amendatory Endorsement form AU14610
Important Payment and Coverage information
Your Gold Protection package contains the following features:
• Accident Waiver Enhancement feature
• Safe Driving Deductible Reward feature
IN WITNESS WHEREOF, Allstate has caused this policy to be signed by its Secretary and its President at Northbrook,
Illinois, and If required by state law, this policy shall not be binding unless countersigned on the Policy Declarations by
an authorized agent of Allstate.
Steven P. Sorenson
President Mary J. McGinn
Secretary
Page 6
R2853-?