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HomeMy WebLinkAboutDOHN CONSTRUCTION - INSURANCE CERTIFICATE (4)ACORD CERTIFICATE OF LIABILITY INSURANCE HOP NC R DATE9/22M 4 DONC-2 022 04 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Linden/Bartels & Noe Agency FC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 1614 Oakridge Drive, Unit A Fort Collins CO 80525 Phone:970-229-9304 Fax:970-229-1398 Dohn Construction, Inc 2642 Midpoint Drive Unit A Fort Collins CO 80515 INSURERS AFFORDING COVERAGE NAIC # INSURERA Employers Mutual INSURER B: Plnnacol Assurance _ INSURER C: _ INSURER D. _ _ T::: INSURER E. V V V Cni/ilfCJ 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 LTR NSR TYPE OF INSURANCE POLICY NUMBER POLI Y�CTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 A X'COMMERCIAL GENERAL LIABILITY IK5725505 10/01/04 10/01/05 PREMISES(Eaoccurence) $100,000 CLAIMS MADE OCCUR MED EXP (Any one person) s5,000 PERSONAL & ADV INJURY $ 1 , 000 , 000 GENERAL AGGREGATE s2,000,000 HGE'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGO s2,000,000 - POLICV PRO LOC JECT A AUTOMOBILE X LIABILITY ANY AUTO 1Z5725505 10/01/04 10/01/05 COMBINED SINGLE LIMIT (Eaaccident) $ 1 , 000 , 000 BODILY INJURY (Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS X X BODILY INJURY (Per accident) - $ HIRED AUTOS NON -OWNED AUTOS I _ PROPERTY DAMAGE (Per accident) $ -- - - - GARAGE LIABILITY AUTO ONLY - EAACCIDENT $ _. OTHER THAN EAACC AUTO ONLY: AGG $ ANY AUTO . $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE s5,000,000 AGGREGATE , $5,000,.000 A X] OCCUR L CLAIMSMADE IJ5725505 10/01/04 10/01/05 _ $ DEDUCTIBLE _ ._ $ RETENTION $ WORKERS COMPENSATION AND X ITORY LIMITS ! ER_ E.L-EACH ACCIDENT $100,000 B EMPLOYERS' LIABILITY 3055407 07/01/04 07/01/05 E.L. DISEASE - EA EMPLOYEE S 100,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER'MEMBER EXCLUDED? E. L. DISEASE -POLICY LIMIT $500,000 If yes, describe under SPECIAL PROVISIONS below OTHER A Builders Risk 115725505 10/01/041 10/01/05 One Loc. $5,000,000 All Loc $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS RE: Fire Station Expansion and Renovation Projects. The City of Fort Collins is named as additional insured in respects to the General Liability. rFOTIGIrATF wnl nFR CANCELLATION CITYOFF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL City of Fort Collins IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Purchasing Division PO BOX 580 REPRESENTATIVES. Ft Collins CO 80522-0580 AU R¢ REPRES ACORD 25 120011081 © ACORD CORPORA