HomeMy WebLinkAboutDOHN CONSTRUCTING - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID R DATE(MMIDD/YYYY)
DORNC-2 09/18/03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Linden/Bartels & Noe Agency PC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1614 Oakridge Drive, Unit A I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Fort Collins CO 80525
Phone:970-229-9304 Fax:970-229-1398
Doha Copnstrruuction, Inc
2642 Midpoint Drive Unit A
Fort Col no CO 80515
INSURERS AFFORDING COVERAGE
INSURER A. Moyers Mutual
INSURER B: Pinnacol Assuran
INSURER C:
INSURER D:
INSURER E:
NAIC #
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.
N*K
LTR
NUU
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MID
DATE MMID
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1, 000, 000
A
X COMMERCIAL GENERAL LIABILITY
1K5725504
10/01/03
10/01/04
PREMISES EMENIWnce
$ 100,000
CLAIMS MADE OCCUR
MED EXP (Any one person)
$ 5 , 0 0 0
PERSONAL &ADV INJURY
$ 1, 000, 000
GENERAL AGGREGATE
$ 2, 000, 000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS-COMP/OP AGO
$2,000,000
POLICY 7 JET LOC
AUTOMOBILE
LIABILITY
A
ANY AUTO
1Z5725504
10/01/03
10/01/04
COMBINED SINGLE LIMIT
(Ea accident)
$ 1, 000, 000
X
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per pennon)
HIREDAUTOS
X
NON -OWNED AUTOS
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
$
(Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO
I
OTHER THAN ��
$
AUTO ONLY: AGG
$
EXCESSAIMBRELLA LIABILITY
EACH OCCURRENCE
$5,000,000
A
X I OCCUR 7CLAIMSMADE
1J5725504
10/01/03
10/01/04
AGGREGATE
$5,000,000
a
DEDUCTIBLE
$
RETENTION $
$
WORKERS COMPENSATION AND
X IMITS ER
TORY L3055407
B EMPLOYERS'ANY PROPRIETORETOR1LITYIPARTNERrE7CECUTIVE 07/01/03 07/01/04
E.L. EACH ACCIDENT
$ 100,000
OFFICERIMEMBER EXCLUDED?
E.L. DISEASE - EA EMPLOYEE
$ 100 000
SPECIAL
SPE ALPR
,
PROVISIONS below
VISIO
E.L. DISEASE -POLICY LIMIT
$500,000
OTHER
A Builders Risk 125725504 10/01/03 10/01/04
1 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.
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
City of Fort Collies NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Purchasing Division IMPOSE NO OBLIGATION OR LIABILITY OF ANY R, ITS AGENTS OR
PO BOX 580 REPRESENTATIVES,
Ft Collins CO 80522-0580 AUTHORIZED REPRESENTATIVE
Michael D. Pierce `
ACORD 25