The URL can be used to link to this page

Home My WebLink About467727 DRAHOTA COMMERCIAL LLC - INSURANCE CERTIFICATE (9)ACORD,N CERTIFICATE OF LIABILITY INSURANCE �/uzola DATE/YYYY) 12//31/231/2013 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(les) 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 hostler in lieu of such endomement(s). PRODUCER Lockton Companies, LLC Denver 8110 E Union Avenue .Suite 700 Denver CO 80237 (303) 414-6000 CONTACT AX A C No A No Est): IF E-MAIL INSURERISI AFFORDING COVERAGE INSURER A: Darwin National Assurance Company 1624 INSURED Drahota Commercial, LLC 1054659 PO Box 272269 2 Fort Collins, CO 80527 INSURER B: Plnnacol Assurance INSURER C : Navigators Insurance Conavany 42307 INSURER p, Depositors Insurance Com env 42587 INSURER F INSURER F COVERAGES DRACOO I CERTIFICATE NUMBER: 11408202 REVISION NUMBER: XXXXXXX 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 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER P LICV FF 12/31/2013 LICV EXP 12/31/2014 LIMITS A GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR Y N 03087571 EACH OCCURRENCE 1000000 DANX PRE 8 (RENTE ante 300,000 MED EXP we rson 10,000 PERSONAL S ADV INJURY $ 1,000,000 GENERAL AGGREGATE s 2,000,000 GENT AGGREGATE LIMIT APPLIES PER: X P X PRODUCTS-COMPIOP AGO s 2000000 a D AUTOMOBILEU NUTY ANY AUTO AUL OWMED ALITEppDULED HIRED AUTOS X NONAUTSSWNED Y N ACPBAPD3006135104 12/31/2013 12/31/2014 (Ea aocWrt) COMBINED SINGLE LIMIT s 1,000,000 X BODILY INJURY (Per persoo) $ XXXXXM BODILY INJURY (Per accident S X PROPERTY DAMAGE S ) It XX)C XXX C UMBRELLA LIAR EXCESS UAB X OCCUR ICI -AIMS -MADE Y N SE13EXC7419871V 12/31/2013 12/31/2014 EACH OCCURRENCE a 5 000 000 7 AGGREGATE s 5,000,000 DED I I RETENTION s S XXXXXXX E WORK ERSCOMPENSATION AND EMPLOYERS' LIABILITY YIN OFFIOER/MEMBERIEXCLUCE09ECUTIVE � (My.a.�"ory In NH) (DESCRIPTION OF OPERATIONS tak NIA N 2286970 7/l/2013 7/I/2014 TATU- O H- X IT ER E.L. EACH ACCIDEW s 1,000,000 E.L. DISEASE-EAEMPLOYEE 1000000 EL DISEA8E-POLIOYuMn1 1000000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES /(Altaoh ACORD 101, Additional Remarks Schedule, N mom space Is required) The City of Fort Collins and Belford Watkins Group, LLC, along with their respective officers, agents and employees, are included as Additional Insureds as respects Liability. 11408202 Cittyy of Fort Collins 215 N. Mason - First Floor 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. ski Th. ArnRn namn and Inns am rcnlalamd ma.ka M ArnrJn ACORDn, CERTIFICATE OF LIABILITY INSURANCE71IJ2014 °A 2/31/2013j 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(les) 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 endomement(s). PRODUCER Lockton Companies, LLC Denver 8110 E Union Avenue .Suite 700 Denver CO 80237 (303) 414 &000 CONTACT FAX INC, NOI: E-MAIL INSURERISI AFFORDING COVERAGE " INSURER A: Darwin National Assurance Company 16624 INSURED Drahota Commercial, LLC 1054659 PO Box 272269 Fort Collins, CO 80527 INSURER B : Pmnacol Assurance INSURER C : Navigators Insurance Company 42307 I . De ositors Insurance Coninany 42587 INSURER nD AnnnI ... "!vrrATE NUMBER. 26ZAAdS RFVIRION NUMRER- XXXXXXX yTHIS 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 TYPE OF INSURANCE AD L SIIBR POLICY NUMBER POLICY EFF 12/31/2013 POLICY EXPLTIR 12/31/2014 LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE EKI OCCUR N N 03087571 EACH OCCURRENCE S 1,000,000 T REocourrenoth PREMISES Ea 3 300,000 MED EXP (Any onePerson) 10 000 PERSONAL a ADV INJURY $ 1000000 GENERAL AGGREGATE s 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: X PRO- X JECT PRODUCTS -COMP/OP AGG $2,000,000 $ D AUTOMOBILE LIABILITY X ANY AUTO ALL AUOpULED AUT X HIREDAUTOS XANUOT'OpND N N ACPBAPD3006435104 12/31/2013 12/31/2014 COMBINEDSINGLE LIMIT $ 1 000 000 BODILY INJURY (Per person) S j} BODILY INJURY (Per acodent $ XXX PROPERTY DAMAGE ccdentl $XXXXXXC $ XXXXXJIX C UMBRELLA LIAR EXCESS LIAR X F IOCCUR CLAIMS -MADE N N SE13EXC7418871V 1 12/31/2013 12/31/2014 EACH OCCURRENCE a 5000000 )( AGGREGATE a 5,000,000 DED I I RETENTION $ s XXX)CXXX B WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN OMY FFILEWMEM EREXCWOEE ECLTIW IMyyeaaneHon, In NHI Mc RNMON OF OPERATIONS teloe NIA N 2..86970 7/t/20t3 7/I/2014 WCSTAT - OTH- X v MI EL PALM ACCIDENT $ 1,000,000 E.L. DISEASE -EA EMPLOYEE I OOO OOO E.L.OISEASE-POLICY LIMIT 1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES /(Attach ACORD 101, Additional Remark; Schedule, M more apace is required) P1123 General Contractor for Fire Station Expansion and Renovation Projects. 3636645 City of Fort Collins Financial Services - Purchasing Division 215 N. Mason Street, 2nd Floor PA. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. L ACORD 25 rho arnRn name ane rnnn are ronlaseren marve ne m v urn TION. All rights ACORD. CERTIFICATE OF LIABILITY INSURANCE 7n/zma DATE 1231/2013/31/2013 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(les) 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 Lockton Companies, LLC Denver 8110 E. Union Avenue .Suite 700 Denver CO 80237 (303)414-6000 CONTACT NAME: FAX A/C, No Ext : A/C No): EMAIL ADDRESS' INSURERIS) AFFORDING COVERAGE INSURER A: United Specialty Insurance Company 12537 INSURED Drahota Commercial, LLC 1302130 PO Box 272269 Fort Collins, CO 80527 INSURER B : Depositors Insurance Company 42587 INSURER C : Pinnacol Assurance Company 41190 I R INSURER F COVERAGES no, ADE01 CERTIFICATE NUMBER' 12196493 REVISION NUMBER: AAXAXNA 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, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTRTYPE OF INSURANCE ADDL SUBR POLICY NUMBER LILY EFF tDono 12/1/2013 POLICY EXP 12/1/2014 LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FKI OCCUR Y N BV01332485 EACH OCCURRENCE 1000000 DAMAGE PREMISESn ( RENTED e 50,000 MED EXP (Any oneperson) Excluded PERSONAL B ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2,000,000 GEN-L AGGREGATE LIMIT APPLIES PER: JE P LI Y X PRO-F71 PRODUCTS - COMPIOP AGG $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO AAUTOVSMlED UTFGppgULED X HIRED AUTOS X q� OSWNED Y N ACPBAPD3006435104 12/31/2013 12/31/2014 Eaamldent) LE LIMIT $ 1000000 BODILY INJURY (Per person) $ )CK)() {}{ BODILY INJURY (Per amidem E XXXXXXX eracedPROPERTY DAMAGE $ XXXXXXX E XXXXXXX UMBRELLA UAB EXCESS LIAB OCCUR CLAIMSb1ADE NOT APPLICABLE EACH OCCURRENCE E XXXXXXX AGGREGATE E XXXXXXX DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS'LIABILITY y/N ANY PROPRIETOPoARTNEREXECUTIVE OFFInfteiCe , I. N., E%LLUDEDI N❑ OE SCRIPTIONOFOPERATIONSI,e. NIA N 2286970 7/1/2013 7/l/2014 STATU- X 7 Y IMIT E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE -POLICY LIMIT 1000000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I(Anach ACORD 101, Additional Remmu, Schedule, "mare space is required) RE: Fire Station Expansion & Renovation Projects (P7474). The City, its officers, agents, and employees are included as additional insured if required by written contract per policy terms and conditions. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 12196493 ..._ _... ..._ Cityy of Fort Collins' Purchasing Division 215 North Mason Street, 2nd Floor PO Box 580 Fort Collins CO 80524 / r . / Al f All rights reserved Th. Arnpn romn mH Inns a.n mnieln.etl m..r.. n. ern