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Home My WebLink About113294 DRAHOTA DEVELOPMENT CO - INSURANCE CERTIFICATE (4)ACORD. CERTIFICATE OF LIABILITY INSURANCE 12/01/2006 06/28 00 PRODUCER Lockton Companies p THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8110 E Union Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Suite 700 ALTER THEV F R E POLICIES BELOW. INSURERS AFFORDING COVERAGE Denver CO 80237 (303) 414-4-6000 INSURED 1051805 Drahota Construction Co. Drahota Development Company LLC INSURER A: Canal Indemnity Co. INSURER B : Zurich American surance C : PtnnaC I A suranC PO Box 272269 -INSURER INSURER D Fort Collins, CO 80527 'A COVERAGES DRACOOI VX THI ER IF TRANDHT BETWI EN HE I UIN AUTHORIZEDNSURA RE DON TOIV CONSOR TITUT A PRODUCER CONTRACT ECE 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. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDD POLICY EXPIRATION DATE MMIDD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire S 100,000 rA X COMMERCIAL GENERAL LIABILITY CLAIMS MADE a OCCUR CGL021119 t 2/01 /2005 12/01 /2006 MED EXP (Any oneperson) $ 5,000 PERSONAL A ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEHL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2 t)DO 000 17 POLICY JPERQ LOC B AUTOMOBILE LIABILITY ANY AUTO CP0375796402 12/01/2005 12/01/2006 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 X BODILY INJURY (Per person) S XXXXXXX ALL OWNED AUTOS SCHEDULED AUTOS X BODILY INJURY raccident) $ XXXXXXX HIREDAUTOS NON -OWNED AUTOS ` '.*'t\/ ►LIB 1 X PROPERTY DAMAGE (Per accident) S XXXXXXX ��-Lry•O- GARAGE LIABILITY > �006 AUTO ONLY- EA ACCIDENT $ XXXXXXX OTER EA ACC AUTO ONLY: AGG $ XXXJOCXX ANY AUTO NOT APPLICABLE lei l .OL $ XXXXXXX EXCESS LIABILITY OCCUR CLAIMS MADE NOT APPLICABLE `y ENT EACH OCCURRENCE S XXXXXXX AGGREGATE S XXXXXXX S XXXXXXX UMBRELLA XXXXXXX DEDUCTIBLE FORM S XXXXXXX RETENTION $ C WORKERS COMPENSATION AND 2286970 07/01/2006 07/01/2007 TU- OT - X T STAim EMPLOYERS' LIABILITY E.L. EACH ACCIDENT S 1,000,000 E.L. DISEASE - EA EMPLOYE 1 000000 E.L. DISEASE - POLICY LIMIT I S 1,000,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSfVEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS RE: Collindale Clubhouse. 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). CFRTIPICATF Mnl 1190 1 X ennnnnsiAi iumioan• iumi000 i =r P ceuccl 1 eT1nu 1912232 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 80522 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. AUTHORIZED REPRESENTATIVE ACORD 25-S (7/97) For questions regarding this cartlacate, contact the number listed to the Troduear motion •bew and "cNy the atent cods VRACOet•. ® ACORD CORPORATION 1988 ACORD. CERTIFICATE OF LIABILITY INSURANCE 12/01/2006 06/288/ o 6 PRODUCER Lockton Companies THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION P ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8110 E Union Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Suite 700 ALTER THECOVERAGE Y P I B Denver 4- 80237 (303) 414-6000 INSURERS AFFORDING COVERAGE INSURED INSURER A: C mni al Ind 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 INSURER D rn A n�Al X> THIS CE IFICATE F INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUINC 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 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDOIYY POLICY EXPIRATION DATE MMR)D LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE N-1 OCCUR CGL021119 12/01/2005 12/01/2006 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire $ 100,000 MED EXP (Any oneperson) $ 5,000 PERSONAL& ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES 1-1 POLICY MR 7 PER: LOC PRODUCTS - COMP/OP AGG $ 2,000,000 B AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS CP0375796402 ^ (.� 12/01/2005 - -1 12/01/2006 z 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 `c%'L Ft;r. NOT APPLICABLE �11 ` afV �Lk. AUTO ONLY ACCIDENT $ XXXXXXX OTHER THAN EAACC AUTO ONLY: AGG $ XXXXXXX $ XXXXXXX EXCESS LIABILITY OCCUR CLAIMS MADE UMBRELLA DEDUCTIBLE FORM RETENTION S NOT APPLICABLE T EACH OCCURRENCE S XXXXXXX AGGREGATE S XXXXXXX S XX)DXi{X XX)LOM S XXXXXXX C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 2286970 07/01/2006 07/01/2007 X WC STAT IT OTH- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1 $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES!EXCLUSIONS 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). CERTIFICATE HOLDER I X I ADDITIONAL INSURED: INSURER LETTER. CANCELLATION 1912233 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Fort Collins 3 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN PO Box 580 Fort Collins, CO 80522 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. AUTHORIZED REPRESENTATIVE C ACORD25-S (7/97) Foraa•.a.n•tie,ml.athis «ela..a, xndad the numb.rlisted mm.•Produmese.el.n.boy..,nd.w.lryo,.disnr..d.'DRAcoor` aACORD CORPORATION 1988