HomeMy WebLinkAboutDYNAMIC HOMES OF COLORADO INC - INSURANCE CERTIFICATE� � DATE (MMlDUlYYYI'�
A�� o CERTIFICATE OF LfABILITY INSURANCE
01/24/2024
�THIS CERTIFICATE fS ISSUED AS A MATTER OF fNFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMA7IVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. TFlIS CERTIFICATE OF INSURANCE DQES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AU7HORIZEQ
REPRESENTATIVE OR Pf20DUCER, AND TNE CERTIFfCATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed.
If Sl18ROGATION 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 NAME: T Austin Olivier
Black Fiills InsuranceAgency PHONE (605) 342-5555 (605) 342 7901
NC No Ezt : NC No :
820 St. Joseph E'MA�� austinolivier@blackhillsagency.com
AD�RESS:
PO Box 3330 INSURER(S) AFFORDING COVERAGE NAIC p
Rapid City SD 57709 iNsuReRa: Acuity Insurance 14784
INSURED uie�mee e.
Dynamic Homes Of Colorado Inc
717 N 22nd Rd
Unadilla, NE 68454
COVERAGES
CER7IFICA7� NUMBER: CL2412426207
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEO TO THE INSUftED NAMED A80VE FOR 7HE POLICY PERIOD
INDICATED. NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT Oft OTHER DOCUMENT WITH RESPECT TO UVHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMI7S SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
� TR TYPE OF 1NSURANCE INSD WV� POLICY NUMBER M�pD EFF MMIDDlYYYY LIMITS
X COMMERCIAL GENEf1AL LIABILITY EACH OCCURRENCE b��000,000
CLAIMS-MADE � OCCUR PREMISES Eaoccurrence y�00,000
MED EXP (Any one person) a 5,000
A Z90859 0�/i1�2024 01/1112�25 p�RSONALBADVINJURY b�'���,���
GEN'LAGGREGATELIMITAPPLIESPER� GENERALAGGREGATE E 2�000,000
POLICY � PR� � 2,OOQ,000
JECT LOC PRODUCTS-COMPlOPAGG S
OTHER: S
AUTOMOBILE LfABILITY COMBINED SINGLE LIMIT a j�QOO,OOO
Ea acddenl
ANY AUTO BODILY INJURY (Per personl 5
q OVVNED SCHEOl1LED Z90859 01/11 /2024 01/1112025 BODiLY INJURY (Per accidonl) E
AUTOS ONLY AUSOS
HIRED NON-ONMED PROPERTY DAMAGE a
AUTOS ONLY x AUTOS ONLY Per accident
5
UMBRBLLA LfAB OCCUR EACH pCCURRENCE b 1.000,000
A EXCESSLfAB CLAIMS-MADE Z908S9 O7/11IZOZA O7/11/2OZS qGGREGATE E��OOO,OOO
DEO RETENTION S E
WORKERS COMPENSATIOM X STn UTE �RH
AND EMPLOYERS' LIABILITY y � N 500.00Q
A ANYPROPRIETORIPARTNERfEXECII�IVE � NIA Z9O$S9 01/11I2O24 O�/li(2025 ����CHACCIOENT E
OFFICER/MEMBER EXCLUDED7
(MenQdtory in NH) E l. DISEASE - EA EMPLOY�� E S�� ��a
�( yes, descnbe under 500 000
QESCRIPTION OF OPERATIpNS bataw f l. DISEASE - POLICY LIMIT S
DESCRIPTIpN pF OPERATIONS! LOCATIONS! VEHtCLES (ACORD 701,Adtllllonal Remarks Schedule, may Ce attached if more space la requlred)
City of Fort Collins
281 N College Ave
Forl Collins
ACORD 25 (2U16103)
CO 80524
INSURER C :
INSURER D :
INSURER E :
INSURER F :
REVISlON NUMBER:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLE� BEFORE
THE EXPiRATION DATE THEREOF, [iOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORI2ED REPRESENTATIVE
O 1986-2015ACORD CORPQRATION. All rights reserved.
The ACORD name and logo are registered marks of ACORb