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HomeMy WebLinkAbout113294 DRAHOTA DEVELOPMENT CO - INSURANCE CERTIFICATE (3)ACORD,M CERTIFICATE OF LIABILITY INSURANCE 12/01/2005 06/21/200 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Lockton Companies 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 AFFORDED BY THE POLICIES BELOW. Denver CO 80237 INSURERS AFFORDING COVERAGE (303) 414-6000 INSURED INSURER A: Canal Indemnity Co. 1051805 Drahota Construction Co. Drahota Development Company LLC INSURER B : Zurich American Insurance PO Box 272269 INSURER C : Pinnacol Assurance Fort Collins, CO 80527 1 INSURER D : eGIES nP ACCV11 NIT 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYI' POLICY EXPIRATION DATE MM/ DIYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE FX7 OCCUR CGL020559 12/01 /2004 12/01 /2005 EACH OCCURRENCE $ 1000 000 FIRE DAMAGE (Any one fire $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PRO - JECT 7 PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY F7 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULEDAUTOS HIRED AUTOS NON -OWNED AUTOS CP0375796401 12/01/2004 12/01/2005 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) $ XXXXXXX X BODILY INJURY (Per accident) $ XXXXXXX X PROPERTY DAMAGE (Per accident) $ XXXXXXX GARAGE LIABILITY ANY AUTO NOT APPLICABLE AUTO ONLY - EA ACCIDENT $ XXXXXXX OTHER THAN EA ACC AUTO ONLY: AGG $ XXXX)= $ XXXXXXX EXCESS LIABILITY OCCUR CLAIMS MADE O UMBRELLA DEDUCTIBLE FORM RETENTION $ NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE $ XXXXXXX s XXXXXXX 9 XXXXXXX $ XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 22$(970 07/01/2005 07/01/2006 X WC 9TATU- OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT I $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL 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). CERTIFI('ATF H L ER I X I ADDITIONAL INSURED' INSURER LETTER ANCELLATION 1912233 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN PO Box 580 Fort Collins, CO SO522 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE WIArWtw YI/t S.J"V i " �.IL�' ACORD25-S(7197) For questions regarding this carliflcate,contaotthe numberllstedinthe 'Producer' section above and spaclythe client code'DRACOai'. ©ACORDCORPORATIOW19B8