HomeMy WebLinkAboutTHE DEER CREEK CORPORATION - INSURANCE CERTIFICATECERTIFICATE OF LIABILITY INSURANCE
American Family Insurance Company
American Family Mutual Insurance Company if selection box is not checked.
6000 American Pky Madison, Wisconsin 53783-0001
Agent's Name, Address and Phone Number (Agt./Dist.) Insured's Name and Address:
The Deer Creek Corporation
Michael Cobb (100-308) 1500 West Hampden Ave., Suite 3D
9200 West Cross Dr., suite 200 Englewood, CO 80110-2039
Littleton, CO 80123
(303) 932-2020
This certificate is issued as a matter of Information only and confers no rights upon the Certificate Holder.
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This is to certify that 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.
POLICY TYPE
TYPE OF INSURANCE
POLICY NUMBER
LIMITS OF LIABILITY
Effective
Expiration
(Mo,Day,Yr)
(Mo,Day,Yr)
Homeowners/
Bodily Injury and Property Damage
Mobilehomeowners Liability
Each Occurrence
Boatowners Liability
Bodily Injury and Property Damage
Each Occurrence
Personal Umbrella Liability
Bodily Injury and Property Damage
Each Occurrence
Farm/Ranch Liability
Farm & Personal Liability Each Occurrence
Farm Employer's Liability Each Occurrence
Statutory ... .
Workers Compensation and
Each Accident
Employers Liability +
Disease - Each Employee
Disease - Policy Limit
General Liability
General Aggregate $ 2,000,000
® Commercial General
05-X70095
7/20/03
7/20/04
Products - Completed Operations Aggregate $ 2,000,000
Liability (occurrence)
Personal and Advertising Injury $ 1,000,000
❑
Each Occurrence $ 1,000,000
❑
Fire Damage (Any One Fire) $ 100,000
Medical Expense (Any One Person) $ 5,000
Businessowners Liability
Each Occurrence + +
Aggregate + +
Automobile Liability
® Owned Autos (Basic form)
05-X70095
07/20/03
07/20/04
Bodily Injury - Each Person $ 1,000,000
Bodily Injury - Each Accident $ 1,000,000
❑ Owned Autos (Comp form)
Property Damage $ 1,000,000
® Hired Autos
05-X70095
07/20/03
07/20/04
Bodily Injury & Property Damage Combined
® Non -owned Autos
05-X70095
07/20/03
07/20/04
❑ Garage liability
Excess Liability
05-X70095
07/20/03
07/20/04
Each Occurrence/Aggregate 9,000,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS
+The individual or partners shown as Insured *" elected to be
covered as employees under this policy.
+ + Products -Completed Operations aggregate is equal to each
occurrence limit and is included in policy aggregate.
The City of Fort Collins
P.O. Box 580
Fort Collins, CO 80522-0580
® Should any of the above described policies be canceled before the
expiration date thereof, the company will mail'(10 days) written notice to the
Certificate Holder named, but such notice shall impose no obligation or
liability of any kind upon the company, its agents or representatives. 30 days
unless different number of days shown.
❑ This certifies coverage on the date of issue only. The above described
policies are subject to cancellation in conformity with their terms and by the
laws of the state of issue.
DATE ISSUED I AUTHhRIZED R PR ENT
8/21/2003 4 , -