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HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATE (2)A Ra CERTIFICATE OF LIABILITY INSURANCE DA 08/23/2013rY> 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 endorsements . PRODUCER CONTACT CS&S/FLOOD & PETERSON INSURANCE INC NAME: PHONE FAX PO BOX 946580 EMAIL Maitland, FL 32794-6580 1-877-724-2669 0�0 ADDRESS: INSURERS AFFORDING COVERAGE NAIC # INSURER A'o oReading, American CasualtyCo Rdin PA . 20427 INSURER B: National Fire Insurance of Hartford 20478 INSURERC INSURER D: DR., SUITE 120 E INSURER E: CO 80525 INSURER F. COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDINGANY 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUER .0 POLICY NUMBER POLICY EFF MM/DD/YV POLICY EXP MM/DD/YV LIMITS A GENERAL LIABILITY y 2090873913 10/03/13 10/03/14 EACH OCCURRENCE S 1,000,000 DAWGE TO RENTED PREMISES(Eo cocuu,ncel $ 300,000 COMMERCIAL GENERAL LIABILITY MED EXP (Anyone person) S 10,000 CLAIMS -MADE a OCCUR PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE S 2,000,000 GENT AGGREMLIMIT APPLIES PER: PRODUCTS-COMP/OP AGO s 2000000 POLICY ECPROT LOC J A AUTOMOBILE LIABILITY 2U90t$73927 10/03/13 10/03/14 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY(Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURVPer accident $ PROPERTY DAMAGE (Per accident) $ NON OWNED HIRED AUTOS AUTOS I S —M I I UMBRELLA UAB OCCUR EACH OCCURRENCE $ AGGREGATE $ EXCESS CLAIMS -MADE DED RETENTION $ IS IS WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y/N 2097624212 03/15/13 03/15/14 �/ /� q TORV LIMITS ry. ER ANY PROPRIETOR/PARTNE WE%ECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE EA EMPLOYEE S 100000 (Mandatory in NH) It yes, describe under E.L. DISEASE -POLICY LIMIT $ SQQ QQQ DESCRIPTION OF OPERATIONS below OTHER WC ATU- TOHY LIMITS OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASEEAEMPLOYEE S E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS LOCATIONS / VEHICLES (Attach Acord 101, Additional Remarks Schedule, it more space Is required) Certificate Holder is added as an additional insured as provided in the blanket additional insured endorsement. GEH I!FICA I E HOLDER CANCELLATION City of Fort Collins SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 580 ACCORDANCE WITH THE POLICY PROVISIONS. Fort Collins, CO 80522 AUTHORIZED r © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD