HomeMy WebLinkAboutDMK COLORADO - INSURANCE CERTIFICATEACORiD CERTIFICATE OF LIABILITY INSURANCE
,M
DATE(MM/DD/YYYY)
04/27/2010
PRODUCER 805.409.2880 FAX 805.409.2881
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ISU Insurance Services of Westlake
License #OG00809
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
2985 E. Hillcrest Drive #201
Westlake Village, CA 91362
INSURERS AFFORDING COVERAGE
NAIC #
INSURED DMK Colorado, LLC I
4706 Westbury Dr.
INSURER A: Indemnity Insurance ,Company of N
A -
INSURERB: -
-
Fort Collins , CO. 80526 i
INSURER C:
,.
INSURER D: �
--
.._.. i
i i
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.
INSR
LTR
ADDT
NSR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE MM/DD/YYYY
POLICY EXPIRATION
DATE MM/DD/YYYY
LIMITS
GENERAL LIABILITY
D37588787
04/27/2010
04/27/2011
EACH OCCURRENCE
$ 1,000,000
X COMMERCIAL GENERAL LIABILITY
DAMAGE TO
PREMISES Ea occu RENTED
$ 100,000
CLAIMS MADE T OCCUR
MED EXP (Any one person)
$ 5,000
PERSONAL & ADV INJURY
$ 1,000,000
A
X
GENERAL AGGREGATE
$ 2,000,000
GENT AGGREGATE LIMIT APPLIES PER:
PRODUCTS - COMP/OP AGG
$ 2,000,000
POLICY PRO LOC
JECT
AUTOMOBILE
LIABILITY
ANY AUTO
D37588787
04/27/2010
04/27/2011
COMBINED SINGLE LIMIT
(Ea accident)
$ 1,000,000
BODILY INJURY
(Per person)
$
A
X
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
X
BODILY INJURY
(Per accident)
$
X
PROPERTY DAMAGE
(Per accident)
$
1.
GARAGE LIABILITY f •
AUTO ONLY- EA ACCIDENT
$
/
- - EA ACC-
OTHER THAN—
ANY AUTO
$ .
AUTO ONLY:-.- — -AGG-
EXCESS'/ UMBRELLA LIABILITY -
- -- -
EACH OCCURRENCE --
$ '
OCCUR CLAIMS MADE
AGGREGATE
$
$
DEDUCTIBLE
$
RETENTION $
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE[--]
OFFICER/MEMBER EXCLUDED?
WC STATU'
TORY LIMITS ER
E.L. EACH ACCIDENT
$
E.L. DISEASE - EA EMPLOYEE
$
(Mandatory in NH)
- -
if yes, -describe under ---_..-
SPECIAL PROVISIONS below
E.L. DISEASE -POLICY LIMIT
$
OTHER
-
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
ity of Fort Collins is named as additional insured.
CERTIFICATE HOLDER CANCELLATION
City of Fort Collins
Finance Dept -Risk Management
PO Box 580
Fort Collins, CO 80522-0580
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 NOPIkLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
25
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