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HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATEACCM& CERTIFICATE OF LIABILITY INSURANCE ATE D07/22/2 V3 07/22/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. 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 PRODUCER CS&S/FLOOD & PETERSON INSURANCE INC CONTACT NAME: PHONE FAX PO BOX 946580 (A/C, No, EXt): (A/C, No): E-MAIL ADDRESS: MAITLAND, FL 32794-6580 Phone - 877-724-2669 Fax - 877-763-5122 INSURER(S) AFFORDING COVERAGE NAIC # American Casual Company of Reading, Pennsylvania INSURER A : � P Y 9. Y 20427 INSURED �O INSURER B: Transportation Insurance Company 20494 INSURER C 'LSD DITESCO, LLC 1 -1 ,1315 OAKRIDGE DR., SUITE 120 FORT COLLINS, CO 80525 INSURER D INSURER : National Fire Insurance Company of Hartford 20478 INSURER F : rnUFoer--Gc CERTIFICATE NUMFSEK: KrVI.WVN NUmt3CK: THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF MWDDrnY Y POLICY EXP MM/DDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $300000 ' x COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR MED EXP (Any one person) 1 r $ D DDD A Y N 2090873913 10/03/2012 10/03/2013 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO �( LOC PRODUCTS - COMP/OP AGG $2,000,000 AUTOMOBILE LIABILITY COMJECT LIMIT (Ea accident) $1,DDD,DDD BODILY INJURY (Per person) ANYSINGLE x ANY AUTO BODILY INJURY (Per accident) B ALL OWNED F7 SCHEDULED AUTOS Auros HIREDAUTOS NON -OWNED AUTOS N N 2090873927 10/03/2012 10/03/2013 PROPERTY DAMAGE (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE AGGREGATE EXCESS LIAB CLAIMS MADE DED RETENTION $ E WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE YIN OFFICER/MEMBER EXCLUDED? (Mandatory in NH) N N 2097624212 03/16/2013 03/15/2014 x WCY LIMIT TORY LIMITS Eft CER E.L. EACH ACCIDENT $100,000 E.L. DISEASE - EA EMPLOYEE $100,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder, City of Fort Collins is added as an additional insured as provided in the .blanket additional insured endorsement. r ;:RTIFICOTF HAI nFR CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE PO BOX 580 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Fort Collins, CO 80522 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE i�Lr'r.Cl�'LU% ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD