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Home My WebLink About113294 DRAHOTA DEVELOPMENT CO - INSURANCE CERTIFICATEACORD. CERTIFICATE OF DATE LIABILITY INSURANCE 12/01/2006 1 06/28/20 6) PRODUCER Lockton Companies P THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8110 E Union Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Suite 700 THE COVERAGE AFFORDED BY THE POLICIES BEL W. -ALTER INSURERS AFFORDING COVERAGE Denver CO 80237 (303)414.6000 INSURED 1051805 Drahota Construction Co. Drahota Development Company LLC INSURERA: Canal Indemnity Co. INSURER B : Zurich American Insurance INSURER C : Pinnacol Assurance PO Box 272269 INSURER D Fort Collins, CO 80527 COVERAGES DRAC001 VX THIS CERTIFICATE OF INSURANCE DOES NCONSTITUTE A CONTRACT BETWEEN THE ER AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERT FI ISSUINC 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MMIDDIVY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire $ 100,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FRI OCCUR CGL021119 12/01/2005 12/01/2006 MED EXP (Any one arson $ 5 000 PERSONAL 6 ADV INJURY $ 1,000000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 000 000 ri POLICY JECT 7 LOC B AUTOMOBILE LIABILITY ANY AUTO CP0375796402 12/01/2005 12/01/2006 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXXX ALL OWNED AUTOS SCHEDULED AUTOS X BODILY BODILY INJURY raccident) $ XXXXXXX HIREDAUTOS NON-OWNED AUTOS t ` 'n\/ 1L1• V PROPERTY DAMAGE (Per accident) $ XXXXXXX .1��yQ• GARAGE LIABILITY + ,406 AUTO ONLY - EA ACCIDENT $ X)O XXXX OTHER THAN EA ACC AUTO ONLY: AGG $ )OCXYXXX ANY AUTO NOT APPLICABLE li Y t t1L $ XXXXXXX EXCESS LIABILITY OCCUR CLAIMS MADE NOT APPLICABLE ^ - +' j MENT EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX $ XXXXXYX ❑ UMBRELLA s XXXXXXX DEDUCTIBLE FORM $ XXXXXXX RETENTION $ C WORKERS COMPENSATION AND 2286970 07/01/2006 07/01/2007 X WC STATU- OTH- EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - FA EMPLOYE $ 1 000 000 E.L. DISEASE - POLICY LIMIT $ 1 000 000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: Collindale Clubhouse. Certificate Holder is named as Additional Insured, but only as respects liability arising out of ongoing operations performed by the Named Insured (excluding Workers Compensation). CF:RTIPII`ATP uni nco ......... .ueuece, rwurer , wrrnu 1912232 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins PO Box 580 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL r 0 DAYS WRITTEN Fort Collins, CO 80522 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE /IC Ail neurcU za-s t rIe i) For au..non. r.a.rmoa Mi. o.nmom, carried the number ea.d In One vrodu"e .action .eo.e and .peotry the clent coa. MRACoor: ® ACORD CORPORATION 1988 ACORD. CERTIFICATE OF LIABILITY INSURANCE 12/01/2006 06/28/zoo 1 PRODUCER Lockton Companies P THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8110 E Union Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Suite 700 ALTER THE COVERAGE AFFORDEDBELOW. INSURERS AFFORDING COVERAGE Denver CO80237 (303) 414-6000 INSURED 1051805 Drahota Construction Co. Drahota Development Company LLC INSURER A: Cana1Indemnt Co. INSURER B : Zurich American Insurance INSURER C : Pinnacol Assurance PO Box 272269 INSURER D' Fort Collins, CO 80527 THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUINC COVERAGES DRAC001 VX IN R R AUTHORIZED P E ENTATIVE OR PRODUCER AND THEIF 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MMIDDIVY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire $ 100,000 A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX I OCCUR CGL021119 12/01/2005 12/01/2006 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY JECpT LOc B AUTOMOBILE LIABILITY ANY AUTO CP0375796402 12/01/2001 12/01/2006 COMBINED SINGLE LIMB (Ea accident) S 1,000,000 X BODILY INJURY (Per Person) 5 XXXXXXX ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per accident) S XXXXXXX HIRED AUTOS NON -OWNED AUTOS u,. ti .., _ - � i X PROPERTY DAMAGE (Per accident) S XXXXXXX (-� GARAGE LIABILITY /2Is Fr;�..N18 AUTO ONLY - EA ACCIDENT $ XXXXXXX ANY AUTO NOT APPLICABLE �\ M.q� G. L OTHER THAN EA ACC AUTO ONLY: AGG $ XXXXXXX $ XXXXXXX EXCESS LIABILITY OCCUR CLAIMS MADE NOT APPLICABLE T EACH OCCURRENCE $ XXXXXXX AGGREGATE 5 XXXXXXX $ XXXXXXX O UMBRELLA DEDUCTIBLE FORM XXXXXXX RETENTION $ 5 XXXXXXX C WORKERS COMPENSATION AND 2286970 07/01/2006 07/01/2007 STATU- X I WQc ER EMPLOYERS'LIABILITY E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE: Traffic Operations Facility. Certificate Holder is named as Additional Insured, but only as respects liability arising out of ongoing operations performed by the Named Insured (excluding Workers Compensation). rFaTlalrerc unl nro I X I .nnrttnu.r rAMrCl I ATInu 1912233 City of Fort Collins PO Box 580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN Fort Collins, CO 80522 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25-5 (7/97) Forquaatlonsregardingthiscartlikde,wrdacttlunumbernatatInthe'ProdusefsectionaboveandapaeHytheclientcode'DRACOei'®ACORD CORPORATION 1988