HomeMy WebLinkAboutDLH MANGEMENT DBA BRICKEY CONSTRUCTION - INSURANCE CERTIFICATEAcoRo„ CERTIFICATE OF LIABILITY INSURANCE D DATE(/
BRICK-4 07/02/02/08OS
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Brown & Brown of Colorado, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
7110 W. Jefferson Ave., #100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Denver CO 80235
Phone:303-980-6265 Fax:720-962-5142 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Admiral Insurance Company 24856
INSURER B
DLH Management dba
DBA Bricke Construction Inc INSURERC
3360 W. 38 h Ave, INSURER
Denver CO 80211 _
INSURER E:
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.
INS D' _--- --.-- --' - '"--__-'-ROLICV EFFECTIVE POLICY EXPIRATION
LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDD/YY DATE(MM/DD[YYI LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$$1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CA00001319201
07/01/08
07/01/09
AMAOFTO-RENTED'
pREMISES(Ea occurenoe)
___..
$$50,000
CLAIMS MADE 1 IOCCUR
MED EXP(Any one person)
$$5,000
A
X Ded $5,000
PERSONAL & ADV INJURY
$$1,000,000
GENERAL AGGREGATE
$ $2, 000, 000
GEN'L AGGREGATE LIMIT APPLIES PER
PRODUCTS COMP/OP AGG
$$2,000,000
X POLICY PRO-
JECT LOC
"------------
AUTOMOBILE
LIABILITY
LIMIT
$
ANY AUTO
(ECOMBINED a acctlent'INGLE
ALL OWNED AUTOS
BODILY INJURY
$
SCHEDULED AUTOS
(Per person)
HIRED AUTOS
BODILY INJURY
$
NON -OWNED AUTOS
(Per accident)
--- - ---
------ ---- ------
PROPERTY DAMAGE
$
(Peracciaent)
GARAGE LIABILITY
AUTO ONLY EA ACCIDENT
$
ANY AUTO
--
OTHER THAN EA ACC
--AGG
$
AUTO ONLY:
$---
EXCESSIUMBRELLA LIABILITY
EACH OCCURRENCE
$
. OCCUR CLAIMS MADE
AGGREGATE
$
DEDUCTIBLE
$
RETENTION $
$-
WORKERS COMPENSATION AND
TORWC LIMITS ER
EMPLOYERS' LIABILITY---
ANY PROPRIETOR/PARTNEWEXECUTIVE
E.L. EACH ACCIDENT
$
OFFICER/MEMBER EXCLUDED?
S yes, uibePRO
E L DISEASE EA EMPLOYEE
- -
$
Ae ISIO
SPECIALPROVISIONSbelow
E. L. DISEASE - POLICV LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Per policy terms, conditions, and exclusions.
City of Fort Collins
PO Box 580
Fort Collins CO 80522
FTCCITY I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO $HALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2001/08)
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.