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Home My WebLink AboutDOHN CONSTRUCTION INC - INSURANCE CERTIFICATEU CERTIFICATE OF LIABILITY INSURANCE OF ID R acoRDOHNC-2 DATE (MM DD YYYY) 09 25 07 PRODUCER LBN Insurance Agency 4848 Thompson Pkwy Johnstown CO 80534 Phone: 970-635-9400 Fax:970-635-9401 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Dohn Construction, Inc 2642 Midpoint Drive Unit A Fort Collins CO 80515 INSURER AEDlployers Mutual INSURER 8'. Plnnacol Assurance INSURER C' INSURER 0: INSURER E: COVERAGES 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 DD' POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDM DATE MMIDDIYY LIMITS GENERAL LIABILITY CH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 1K57255 10/01/07 10/01/08 MAGE-TO(Ea accwrence) $100,000 CLAIMS MADE a OCCUR rPREMISES D E%P (Any one person) $ 5,000 RSONAL B ADV INJURY $1,000,000 X Blanket Addrl Ins X Blanket waiver GENERALAGGREGATE $2,000,000 GEN' L AGGREGATE LIMIT APPLIES PER'. PRODUCTS-COMP/OP AGG s21000,000 POLICY X JE,0� LOC A AUTOMOBILE LIABILITY ANY AUTO 1Z57255 10/01/07 10/01/08 COMBINED SINGLE LIMIT (Ea accident) E1, 000,000 X BODILY INJURY (Per parson) E ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY (Per aceident) $ HIRED AUTOS NON -OWNED AUTOS X PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ OTHER THAN EAACC $ ANYAUTO $ AUTO ONLY'. AGO EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $5,000,000 A X OCCUR CLAIMS MADE 1J57255 10/01/07 10/01/08 AGGREGATE $5,000,000 $ DEDUCTIBLE $ RETENTION $ B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE 3055407 07/01/07 07/01/08 X TWC LIMITS ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 OFFICFR/MEMBER EXCLUDED? If yes, descnba under SPECIAL PROVISIONS below E. L. DISEASE - POLICY LIMIT --- $1,000,000 OTHER A Builders Risk 1I57255 10/01/07 10/01/09 One Loc. $5,000,000 All Loc $5,000 000 DESCRIPTION OF OPERATIONS / LOCATIONS [VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ALL OPERATIONS - ALL LOCATIONS City of Fort Collins PO Box 580 Fort Collins, CO 80522-0580 I A NI MLLR I ILI N CITYOF7 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIC DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE 1 IMPOSE NO OBLIGATION OR LL REPRESENTATIVES. AUTHORIZED REPRESENTATIVE LEFT, BUT FAILURE TO DO SO SHALL ON THE INSURER, ITS AGENTS OR ACORD O ACORD IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. (zoovos)