HomeMy WebLinkAboutCD INC - INSURANCE CERTIFICATE.4(. VKU
CERTIFICATE OF LIABILITY INSURANCE 6/1/2010
DATE (MM/DD/YYYY)
4/1/2010
PRODUCER Lockton Companies-, LLC Denver
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
8110 E Union Avenue
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Suite 700
Denver CO 80237
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(303) 414-6000
INSURERS AFFORDING COVERAGE
NAIC #
INSURED CD Inc.
1055025. Consolidated Divisions, Inc.
5585 W. Airport Road
Sedalia, CO 80135
INSURER A: The Travelers Indemnity Company
25658
INSURER B : Travelers Property Casualty Co of America
25674
INSURER C : Pinnacol Assurance Company
41190
INSURER D :
INSURER E :
COVERAGES COND103 VX THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING
INQIIDCD/Q% A"TUnDl7Cn DCDDCQCUTATIVC nD DDnnnrCD nun TUC r•e DTlnnerr un� nre
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
ADD'L
INSRD
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DD/YY)
LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE a OCCUR.
DTC07884PI lAl OIND
4/1/2010
4/l/2011
DAMAGE TO RENTED
PR MI a occurence
$ 250,000
MED EXP (Any one person)
$ 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
PRO -
X
POLICY JECT LOC
B
AUTOMOBILE
LIABILITY
ANY AUTO
DT8107884PI lAlOTIL
4/1/2010
4/1/2011
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
X
BODILY INJURY
(Per person)
$ XXXXXXX
ALL OWNED AUTOS
SCHEDULED AUTOS
X
BODILY INJURY
(Per accident)
$ XXXXXXX
HIRED AUTOS
NON -OWNED AUTOS
X
PROPERTY DAMAGE
(Per accident)
$ XXXXXXX
GARAGE LIABILITY •
ANY AUTO
-
NOT APPLICABLE
AUTO ONLY - EA ACCIDENT
$ XXXXXXX
OTHER THAN EA ACC
$ XXXXXXX
AUTO ONLY: AGG
$ XXXXXXX
B
EXCESS/UMBRELLA LIABILITY
X OCCUR CLAIMS MADE
DTSMCUP7884P1 IAIOTIL
4/1/2010
4/1/2011
EACH OCCURRENCE
$ 5 000 000
AGGREGATE
$ 5,000,000
$ XXXXXXX
UMBRELLA
$ XXXXXXX
DEDUCTIBLE X FORM
$ xxxxXXX
RETENTION $
C
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY Y / N
4069626
6/I/2009
6/1/2010
X I WC STATU- I JOTH_
TORY LIMITS I ER
E.L. EACH ACCIDENT
$ 1,000,000
ANY PROPRIETORfPARTNER/EXECUTIVE a
OFFICER/MEMBER EXCLUDED?
- _
E.L. DISEASE - EA EMPLOYEE
$ 1,000,000
(Mandatory in NH)
If yes, describe under
SPECIAL PROVISIONS below
_T
E.L. DISEASE - POLICY LIMIT
$ 1 000 000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
RE: Poudre Trail Rehabilitation.
10709787
City of Fort Collins
300 Laporte Ave.
Fort Collins CO 80522
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ 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
AUTHORIZED
ACORD 25 (2009/01)
ACORD CORPORATION_ All rinhts rPQP_r~1
The ACORD name and logo are registered marks of ACORD
cnr Fnr mleetinne mnardinn this fifirate. enntart the nnnnhor lie -d in the'Prn rarer' section ahn— and sneriW the Client r.nde'rnNnfn3'.