HomeMy WebLinkAbout467727 DRAHOTA COMMERCIAL LLC - INSURANCE CERTIFICATE (11)ACORDrt, CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE
I z/31/zo14
DATE
6/26//26/2014
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 endomement(s).
PRODUCER Lockton Companies
8110 E Union AvenueIk
Stilts 700
Denver CO 80237
(303)414-6000 4ulINSURERIS)
CONTACT
N M
a No Eft): FAX ac No
E-MAIL
AFFORDING G
c
INSURER A: Darwin National Assurance Company
16624
INSURED Drahota Commercial, LLC
1054659 PO Box 272269
Fort Collins, CO 80527
INSURER B: Plnnacol Assurance
INSURER c: Navittators Insurance Company
42307
Denositors Insurance Company
42587
INSURER F
Cr1VFRArgFS IIRAro f)l CFRTIFICATF NIIMRFRr 7676645 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
TR
TYPE OF INSURANCE
AD L
SUB
POLICY NUMBER
POLICY EFF
POLICCY EXP
LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 1 OCCUR
N
N
03087571
12/31/2013
12/31/2014
EACH OCCURRENCE
1000000
DAMAGE O RENTED
PREMI a olrtence
300 DDD
MED EXP An one rmn
10,000
PERSONAL B ADV INJURY
$ 1000000
GEN'L AGGREGATE LIMIT APPLIES PER:
POLICY PRO
OT X❑ LOG
OTHER
GENERAL AGGREGATE
$Zo0D000
PRODUCTS - COMP/OP AGO
$ 2 000 000
$
D
AUTOMOBILE
LIABILITY
ANY AUTO
ALL OrED SSCHEERULED
AUTO
HIRED AUTOS X AUTOS ED
N
N
ACPBAPD3006435104
12/31/2013
12/31/2014
Ea COMBINEDNSINGLE LIMIT
$ 1,000,000
X
BODILY INJURY (Per person)
$ XXXXXxx
BODILY INJURY (Per acddent
$ XXXXXXX
X
GE
PROPERTY DAMAGE
$ XXXXXXX
$ XXXXXXX
C
UMBRELLAUAB
EXCESS LIAB
X
OCCUR
CLAIMS -MADE
N
N
SEI3EXC7418871V
12/31/2013
12/31/2014
EACH OCCURRENCE
$ 5,000,000
J{
AGGREGATE
$ 5,000,000
DECT I RETENTIONS
$ XXXXXXX
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
OFFICEMBER 0PET0PJEARTNED4ECVrIVE
(Myrmcn., In NH)
If
DESCRIPTON OF OPERATIONS telex
N/A
N
2286970
7/1/2014
7/1/2015
PER OTH
X STATUTE
E.L. EACH ACCIDEW
$ 1000000
E.L DISPASE-EA EMPLOYEE
1000000
E L. DISEASE - POIICV LIMIT
1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD lot, Additional RemaMe Schedule. my be attached If mom space 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
P.O. 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.
C
Thu Ar.nRn .ann. and Inns aw roninfurod ,nerlru of arinRn