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HomeMy WebLinkAboutDL Cohen Construction Company - Insurance Certificate 'a DATE(MMIDD/YYYY) ARID CERTIFICATE OF LIABILITY INSURANCE 12/26/2024 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 NAME: T Andrew Safe CRS Insurance Brokerage PHONE 303 996 7800 ac No:303 757-7719 tAIC9780 S Meridian Blvd Suite 400 E-MAIL Englewood CO 80112 ADDRE : asafe crsdenver.com INSURERS AFFORDING COVERAGE NAICY INSURER A: Pinnacol Assurance 41190 INSURED DLCOH-1 INSURER B: United Specialty Insurance Co 12537 DL Cohen Construction Company LLC INSURERC: General Security Indemnity Company of Arizona i 20559 PO Box 1244 Englewood CO 80150 INSURER D: Employers Mutual Casualty Co__ 21415 INSURER E: - INSURER F COVERAGES CERTIFICATE NUMBER:142040695 REVISION NUMBER: 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 REOUIREMENT, 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. A�6L -- -- EFF POLICY EXP ILTRi TYPEOFINSURANCE IN WV POUCYNUMBER MMlDD/YYYY MMNDIYYYY LIMITS LTR I C X COMMERCIAL GENERAL LIABILITY GSA463912120103 1/3/2025 1/3/2026 64CHOCCURRENCE $1.000.000 AGE TO EN CLAIMS-MADE X : OCCUR PREMISESJE- a occurrence $50,000_ MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 - POLICY Ln jEO I LOG PRODUCTS-COMKOPAGG $2,000,000 OTHER: 1/312025 1/3l2026 COMBINED SINGLE LIMIT $1,000,000 D AUTOMOBILE LIABILITY BX61791 (Eaaccdenq____—__-_--_ _—_-------- -i BODILY INJURY(Per person) $ X ANY AUTO OWNED SCHEDULED BODILY INJURY(Per accident) $ A AUTOS PROPERTY DAMAGE AUTOS ONLY X I X (_Per accideMl__....__--- -- $ HIRED NON-OWNED I ------- - - - AUTOS ONLY AUTOS ONLY $ B UMBRELLA LIAB !'X OCCUR STN2552338 1/3/2025 1 113/2026 i EACH OCCURRENCE $3,000,000 X EXCESS UAB AGGREGATE $3,000,000 _ CLAIMS-MADE $ i DED I X I RETENTION$ A WORKERS COMPENSATION 4133242 8/1/2024 i 8/1/2025 X Is ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y� j E.L.EACH ACCIDENT _ $1,000,000 - OFFICER/MEMBEREXCLUDED? N/A (Mandatory In NH) I E.L.DISEASE_EA EMPLOYEE $1,000_000 II as,describe under E.L.DISEASE-POLICY LIMIT $1,000.000 DESCRIPTION OF OPERATIONS bebw D Leased/Rented Equipment 6X61791 1/3l2025 1/312026 Limit 400,000 Deductible 1.000 i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins 281 N College Avenue AUTHORIZED REPRESENTATIVE Fort Collins CO 80524 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 10495: 2 of 2