HomeMy WebLinkAboutDIG BOSS, LLC - INSURANCE CERTIFICATEq`�R�'� CERTIFICATE OF LIABILITY INSURANCE DAT1/i Zo24Y��
THIS CERTIFICATE IS 1SSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS 11PON THE CERTIFICATE�HOLDER. TFfIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTEA THE COVERAGE AFFOROED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A C4N7RACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REpRESENTATIVE OR PRODUGER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDI710NAL INSURED, the poUcy(iea} must have ADDITIONAI INSURED provisiona or be endorsed.
If 5UBROGATION IS WAIVED, aubject to the terms and conditions of the policy, certain policies may require an endoraement. A atatement on
this certificate does not confer ri hts to the certiifcate holder in Heu of such enrlorsement(s}.
PRODUCER ONTA T
NA_ME: LOfI ROS2
Arthur J. Gallagher Risk Management Services, LLC PHor,e Fnx
42750 Merit Drive Suite i 000 _(9c�._r�. �: � �,-, c, r�.o�:
E-MAII
Dallas 7X 75251 aooRass: Lori_Rose@�.cJom ___
INSURED
Dig Boss, LLC
PO Box 368
Watkins, CO 80137
IMSURER{S)AFFORDIN6 COVERA(iE NAIC Y
_ ..
iNsuREA n: Nationwide Mutual Insurance Company 23787
NE�GLOC-Ot INSURER B: AMC� I11SUC311C0 COIYlp2fl'r/ 19100
iNsuReR o: Markei American Insurance
INSURER E :
COVERAGES CERTIFICATE NUMBER:2113975829 REVISI013 NUMBER:
TH1S IS TO CERTIFY THAT THE POLICIES OF kNSURANCE LISTED BELOW FiAVE BEEN ISSl1ED TO THE INSURED MAMED ABOVE fOR THE POLICY PERIOD
INDICATED. NOTWITHSTAiJDING ANY RE�UIREMENT, TERM OR CONDITION OF AtJY CONTRACT OR OTHER DOCUMENT WITH RESPEC7 TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PER7AIN, THE INSURANCE AF�ORDED BY THE POLICIES DESCRIBED FiEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN F�EDUCED 8Y PAID CLAIMS.
ILTR TYPE OF INSURANCE ADOL -CIBR AOLICY NUMBER ^ MMlDCY YYY M� DDIVYYY LIMITS
A X COMMERCIALGENERALLIA8ILITY ACP GLO 3110341248 411I2023 4/1l2024 EACHOCCURRENCE S 1,OOO,Q00
ICLAIMS-MAOE I X p�CVA �6i1F,�A7`iET6iiEfITED
. I PREMISfiS�accur�ence� s�,000.000
MED EXP (Ao one person S 10 000
PERSONAL 8 AOV INJURY S 1,OOO,Q00
GEN'LAGGREGATELIMITAPPLIESPER. GENfRqLAGGREGATE $2,000.000
POLICY�I ECT �ILOC PRODUCTS-COMPlOPAGG 52,000,000
OTMER: �
C AUTOM091LE LIA8ILITY ACP BAPO 3110341248 4/1/2023 4/�/ZpZq MBINED IN LE LlMIT g �,000,000
�Ea e�dg@n j_�
X RNY AUTO BODILY INJURY {Per person) $
OWNED SCHEDULED BODILY INJUFiY (Per aaldBnl) S
_ RUTOS ONLY AUTOS
X HIRED x MON-OWNED PROPERTY pAMAGE $
AUTOS ONLY AVTOS ONLY SPer Bcddent��� _�_�__
S^
e X UMBRELLALIAB X OCCUA ACP CAA 3110341248 4J7I2023 411l2024 EACHOCCUFRENCC 55,000,000
EXCESSl1A6 ClAlMS-MAOE AGGREGATE 35000,000
OEO � RETENTION S
g WORKERS COMPENSATION ACP WCA 3110341246 411I2023 4l112024 X SYATUTE ERH
ANO EMPLOYERS' LIABILITY Y! N �
ANYPHOPHIETGRIPAHINGRlEXECUTIVG ❑ N�A E.L EACNACCIDENT 51 000,000
OFFICER/MEMBEREXCLU�ED?
(Msndalory in NH? E.L OISEASE • EA EMPLOYEE 5 1 000,000
If yes. deStribe untl0r �i� � " � ""
OESCRIPTION OF OPERATIONS below E.L OISEASE � POLICY LI�+IT S 1 000,000
A Infane Manne ACP CIM 3110341248 4f1l2023 4I1l2024 LeasedlRemea Equ�p $100,000
d MKLM4EUE1011A1 4/1/2023 41112024 �nslellationFloater $100,000
Excess Lisbitity (SMxSM) Limd (Ea OcdAGG) 55,000 000
DESCRIPTION OF OPERATION5/ LOCATIONS! VEHICiES (ACORD 101, Addi[ionel Remarks Schedule, may 6a etteehed if more epace ie requlreAj
City of Fork Collins is inGuded as additional insured on ihe General Liability with respect to ongoing operations of the named insured for the certif�cate holder as
required by written contract.
CELlAT10N
SHOULD ANY �F THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
TFfE EXPIRATION �ATE THEREOF, N�FICE WILI. 9E DELIV�RED IN
City of Fort Collins ACCORDANCE WITH THE POLICY PROYISIONS,
Attn: Engineering Depariment
281 North College Avenue
Fort Collins CO $0524 AUTHORI2EOREPRfiSENTATIVE
USA j �� j��'j��
fni t/ v
m 1998-20i5 ACORb CORPORATION. All rights reserved.
ACORD 25 (2Q16l03) The ACORD name and logo are registered ma�ks of ACQRD