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HomeMy WebLinkAbout102829 DON KEHN CONSTRUCTION - INSURANCE CERTIFICATE (3)ACORO® CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDDIYYYY) 10/19/2018 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 have ADDITIONAL INSURED provisions or 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 CONTACT Dana Stewart, CIC, CISR NAME: Flood and Peterson ,CONNo Ext : (970) 266-7149 ac, No): (970) 506-6845 E-MAIL DStewart@floodpeterson.com ADDRESS: PO Box 578 INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Cincinnati Insurance Co 10677 Greeley CO 80632 INSURED INSURER B : INSURER C : Don Kehn Construction Inc. INSURER D : 6550 S. County Road 5 INSURER E : INSURER F : Fort Collins CO 80528 COVERAGES CERTIFICATE NUMBER: Master 2018-19 REVISION NUMBER: 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 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 ADUL INSD 5U5K WVD POLICY NUMBER POLICY EFF MMIDO POLICY EXP MMlDD/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1.000,000 CLAIMS -MADE ® OCCUR DAMAGE TO RENTE17 PREMISES (Ea occurrence $ 500.000 MED EXP Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 A EPP 045 96 66 11/01/2018 11/01/2019 GEN'LAGGREGATELIMIT APPLIES PER : GENERAL AGGREGATE $ 2,000,000 JECT❑LOC PRODUCTS-COPIOPAGG $POLICY©PRO-2,000,000 $ OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ 1,000,000 BODILY INJURY (Per person) $ ANY AUTO A OWNED SCHEDULED AUTOS ONLY AUTOS EPP 0459666 11/01/2018 11/01/2019 BODILY INJURY (Per accident) $ PROPERTY DAMAGE Per accident $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY H $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 3.000,000 AGGREGATE $ 3,000,000 A EXCESS LIAB CLAIMS -MADE EPP 045 96 66 11/01/2018 11/01/2019 DED I X RETENTION $ 0 $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y t N PER OTH- STATUTE ER ANY PROPRIETOR,PARTNER/EXECUTIVE ElN OFFICER/MEMBER EXCLUDED? / A E.L. EACH ACCIDENT $ (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below EL. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS ! VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space Is required) Certificate holder is included as Additional Insured as required by written contract with respects to General Liability and Automobile Liability. GtK 1 II-IGAI t SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN The City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. PO Box 580 AUTHORIZED REPRESENTATIVE ��---;j-- Fort Collins CO 80522 ' (12( ld © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD