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Home My WebLink About467727 DRAHOTA COMMERCIAL LLC - INSURANCE CERTIFICATE (13)ACORD. CERTIFICATE OF LIABILITY INSURANCE I ze 1no 14 GATE I 1/26/201426/2014 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(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 8110 E. Union Avenue .Suite 700 Denver CO 80237 (303)414-6000 CONTACT NAME' AX A No Eat : JC No): E-MAIL DDRE INSURERISI 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 Commariv, 42587 INSURERC: Pinnacol Assurance Cornoany 41190 INSURER N F: in IA4An] oernetnM MnaaGCo YYYYYYX V 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 vivin POLICY NUMBER POLICYEFF IDDNYYY PYYY OLICY EXPINS) LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR Y N BV01443158 I2/1/2014 12/1/2015 EACH OCCURRENCE S 1000000 DAMAGE( RENTED PREMISESSRENT rzence) $ SO OOO MED EXP (Any oneperson) Excluded PERSONAL B ADV INJURY $ 1000000 GENT AGGREGATE LIMIT APPLIES PER: POLICY JECT LOC OTHER GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOPAGO $ 2,000,000 $ B AUTOMOBILE LIABILITY X ANY AUTO AUTOWNED AUTOSULED X HIREDAUTOS X AUTOSWNED Y N ACPBAPD3006435104 12/31/2013 12/31/2014 EO MBBIIINHEanoD SINGLE LIMIT $ 1 000 00O BODILY INJURY (Per person) $ XXXXXXX BODILY INJURY(Per accident $ XXXXXXX PROPERTY acciden DAMAGE $ XXXXXXX $XXXXXXX UMBRELLA LIAR EXCESS LIAB OCCUR CLAIMS -MADE NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX AGGREGATE S XXXXXXX DED RETENTION $ $ C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERiE%ECUTIVE OFFICERMEMBER EXCLUDED? El (Mandatory in MR) DESCRIPTION OF OPERATIONSEebn NIA N 2286970 7/1/2014 7/12015 X STATUTE FR E.L. EACH ACCIDENT $ 11000,000 E.L. DISEASE - EA EMPLOYEE 1,000,000 EL OISHSE- POLICY(MIT a 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, may be attached If more 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. 12196493 Cityy of Fort Collins' Purchasing Division 215 North Mason Street, 2nd Floor PO Box 580 Fort Collins CO 80524 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. TION. All rights reserved