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Home My WebLink About384484 DANIELS CONSTRUCTION - INSURANCE CERTIFICATEACORD CERTIFICATE OF LIABILITY INSURANCE OP ID D DATE(MM/DDIYYYY) DANIE-1 03107106 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Colorado East Insurance - 1 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Lamar Office HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P. 0. Box 1017 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lamar CO 81052-1017 Phone:719-336-2800 Fax:719-336-2371 INSURED Daniels Construction 201 E Washinggton St Lamar CO 81052 COVERAGFS INSURERS AFFORDING COVERAGE INSURERA: PTO Builders INSURER B: 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. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DDIYY EXPIRATION OLICY MM/DDIYY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE X1 OCCUR WPIN 5004800 06/28/05 06/28/06 EACH OCCURRENCE $ 1000000 pREMISES(Eaoccurence) $ MED EXP(Anyone person) $5000 PERSONAL &ADV INJURY $ 1000000 GENERAL AGGREGATE $ 1000000 GEN'L AGGREGATE LIMIT APPLIES PER: X I POLICY PROECT LOC J PRODUCTS - COMP/OP AGG $ included AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) AUTO ONLY -EA ACCIDENT $ $ GARAGE LIABILITY ANY AUTO y,.•I�5 -I� �` M, ,�•/�16 � OTHER THAN EA ACC AUTO ONLY: AGG $ $ EXCESS/UMBRELLA LIABILITY OCCUR CLAIMS MADE DEDUCTIBLE RETENTION $ EACH OCCURRENCE $ AGGREGATE $ $ $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? Des, describe under SPECIAL PROVISIONS below TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT 1 $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS The City of Ft Collins is listed as an additional insured. CERTIFICATE MOLDER CANCELLATION City of Ft Collins John Stephen PO Box 580 Ft Collins CO 80522 CITYFTC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL 6 MXXM2X OLMAIL _ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Arnan gs r9nnitnRi r[a7�T.T•l:a7au:7J•l c7-TA a i1`exP.] 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. ACORD 25 (2001108)