HomeMy WebLinkAbout450506 DITESCO - INSURANCE CERTIFICATEClient#: 47025
ACORQu, CERTIFICATE OF LIABILITY
INSURANCE
DATE(MMIDD/YYYY)
PRODUCER
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Flood & Peterson Insurance Inc
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
4821 Wheaton Drive
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P O Box 270370
Fort Collins, CO 80527
INSURERS AFFORDING COVERAGE
NAIC #
INSURED
DIteBCO, LLC
3155 Rookery Road
Fort Collins, CO 80528
INSURER A: CNA Insurance Company
INSURER B:
INSURER C:
INSURER D:
INSURER E:
COVERAGES
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
POLICYEFFECTIVE
DATE MM DD
POLICY EXPIRATION
DATE MM/DD
LIMITS
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 5x1OCCUR
B2090873913
10/03/08
10/03/09
EACH OCCURRENCE
$1 Q00 ODD
DAEE MAGE TO RENTd.ED
$300OOO
MED EXP (Any one person)
$10 000
PERSONAL &ADV INJURY
$1000000
GENERAL AGGREGATE
s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO-
JECTLOG
PRODUCTS � COMP/OP AGG
$2 00O 000
A
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIREDAUTOS
NON -OWNED AUTOS
B2090873927
10/03/08
10/03/09
COMBINED SINGLE LIMIT
(Ea accident)
$1,000,000
X
BODILY INJURY
(Per person)
$
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EAACCIDENT
$
OTHER THAN EA ACC
AUTO ONLY: qGG
$
$
EXCESS/UMBRELLA LIABILITY
OCCUR F1 CLAIMS MADE
DEDUCTIBLE
RETENTION $
EACH OCCURRENCE
$
AGGREGATE
$
5
$
$
A
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
297624212
03/15/08
03/15/09
X WC STATU- OTH-
IER
E.L EACH ACCIDENT
$100,000
E.L. DISEASE - EA EMPLOYEE
$100,000
E.L. DISEASE -POLICY LIMIT
1$500,000
A
OTHER Professional
MCH288252590
10/05/08
10/05/09
$1,000,000 per claim
$1,000,000 Aggregate
$5,000 Deductible
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Fort Collins Utilities
Attn. Link Mueller
3036 Environmental Drive
Fort Collins, CO 80522
I ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
HEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL �' 0_ DAYS WRITTEN
TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
AUTHORIZED REPRESENTATIVE
y-
�l000R
ACORD 25 (2001108) 1 of 2 #S429204/M42721 A
r:XR
198E
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 25-5 (2001108) 2 of 2 #S429204/M427218