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Home My WebLink About102829 DON KEHN CONSTRUCTION INC - INSURANCE CERTIFICATE (12)Client#: 51160 DONKEI ACORD_ CERTIFICATE OF LIABILITY INSURANCE GATE11/4/2004/20IYVV13 YI 1 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(iss) 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 Flood & Peterson Ins., Inc. P. O. BOX 578 Greeley, CO 80632 CONTACT NAME: Dana M. Stewart PHONE AIC 970 266 7149 970 506 6845 E#: AIC No: IL ADDRESS, Dstewart@floodpeterson.com ADDRESS: 1.:.•• P INSURER(S)AFFOROING COVERAGE NAICN 970 356-0123 INSURER A: The Cincinnati Insurance Compan 10677 INSURED Don Kehn Construction Inc. /1 6550 S. County Road 5 1 Z 2 Fort Collins, CO 80528 INSURER B : INSURER C: INSURERD: INSURER E: 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 FORTHE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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 DDL INS SUER POLICY NUMBER POLICY EFF MM/DD POLICY EXP MMIOD LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FxIOCCUR X PDDed:1,000 CPP1084111 11/01/2013 11101/2014 EACH OCCURRENCE It000000 Ep PREMISES Eeo. sops s500000 MEDEXP(Anyompenon) $10000 PERSONAL & ADV INJURY $1000,000 GENERAL AGGREGATE $2 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: 17 POLICY-X] PRO- LOC JECT - COMP/OP AGG $2000,000 $ A AUTOMOBILE LIABILITY JAANYAUTO SCHEDULED RED AUT05 X AUTOS 0 Car CPPI084111 11/01/207311101/201 SINGLE LIMIT t 1,000,000 Maccidept URY (Per person) $LLOWNED URY (Px apcldeM) $AUTOSNON-OWNED DAMAGE ntrWe $AUTOS $A )( UMBRELLALIAS EXCESS LIAB X OCCUR CLAIMSWADE CPP1084111 1/01/2013 11/01/201 EACHOCCURRENCE $3000000 AGGREGATE s3 000 000 DED RETENTION$ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNERIEXECUTIVE= OFFICEWMEMBER EXCLUDED? (Mandatory In NH) If yea. describe under DESCRIPTION OF OPERATIONS below NIA WC STATU- OTH- E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE -POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Project Description: Mining Reclamation Agreement regarding Arapahoe Bend Natural Area The following are Additional Insureds as respects General Liability only if required by written contract and coverage applies only as respects work performed by the Insured for the Additional Insureds. All coverage terms, conditions and exclusions of the policy apply. Additional Insureds: City of Fort Collins. This Certificate of Insurance represents coverage currently in effect and may or may not be in compliance with any written contract. City of Fort Collins PO Box 580 Fort Collins, CO 80522-0580 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) 1 of 1 #S840732/M840501 1988-2010 ACORD CORPORATION. All rights reserveO. The ACORD name and logo are registered marks of ACORD KXM