Loading...
HomeMy WebLinkAboutDMD CONSTRUCTION INC - INSURANCE CERTIFICATE (2)From: Ton Gnscavage FaXID:(970) 484-4165 Page 1 of 2 Date:21'72014 09:17 AM Page:1 of 2 DMDCO-1 CERTIFICATE OF LIABILITY INSURANCE DATED/YYYY) 02/07zro7n a 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 endorsement s PRODUCER Phone:970482-7747 CCAONTTACT Brown & Brown Inc Fax: 970-484-4165 PHONE FAX 4532 Boardwalk Dr, Suite 200 AIC Ne Extl(AIC, No): Fort Collins, CO 80525 EJAAIL Tyler B. Allen ADDRESS_ - INSURER A : Westfield Insurance Coro INSURED DMD Construction, Inc. INSURERB: 3801 Weicker Dr Ft Collins, CO 80524 INSURER C INSURER D INSURER E INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 12 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. INSR LTR TYPE OF INSURANCE POLICY NUMBER MMADIYYYY MMADIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 PREMISES Es occurrence $ 500,00 A X COMMERCIAL GENERAL LIABILITY CWP5113278 02l25/14 02/25115 CLAIMSJAADE a OCCUR MED EXP (Any one person) $ 5,00 PERSONAL &ADV INJURY $ 1,000,00 GENERAL AGGREGATE $ $000,00 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ 2,000,00 $ 1-1 POLICY X PRO LOC AUTOMOBILE LIABILITY O eBBINE�DD SINGLE LIMIT (EeA 1 000 p0 ANY AUTO CWP5113279 O7J25114 02125J15 BODILY INJURY (Per person) $ BODILY rJ JJRY (Per ecddent) $ ALL OWNED SCHEDULED AUTOS AUTOS NON -OWNED HIRED AUTOS AUTOS I DAMAGE$ Per PERTacci nt $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ AGGREGATE $ E%CESS LU18 CLAMS -MADE DED RETEN7gN $ WORKERS COMPENSATION WC STATU- OTH- ER AND EMPLOYERS' LUIBLITY ANY PROPP.IETORIPARTNER�CUTIVE YIN E.L. EACH ACCIDENT $ OFFICERMIEMBER EXCLUDED? ❑ (Mandatory In NH) N/A E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE- POLICY LIMB S It yes, desbe under DESCRIPTION OF OPERATIONS below A uilders Risk P5113279 02/25114 02125115 Bidr Risk 100,00 I i Ded 50 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remark* Schedule, if mom space Is required) Location 5295 Beech Craft, Loveland, CO - City of Fort Collins and The City of Loveland are included as Additional Insured with respects to General Liability per conditions and forms shown on page 2. Fax# 221-6327 CERTIFICATE HOLDER CANCELLATION FTCILOV SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE NTH THE POLICY PROVISIONS. Fort Collins -Loveland Municipal Airport 4900 Earhardt Road Loveland, CO 80538 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD From:Tori Griscavage FaxID:(970) 484-4165 Page 2 of 2 Date:2772014 09:17 AM Page:2 of 2