HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATE (16)ACOR" CERTIFICATE OF LIABILITY INSURANCE
DATE(MMlDDIYYYO
03/07/2019
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
NTACT Brianne Danielson, CISR
NAME:
Flood and Peterson
PHONE (970) 266-7118 FAX (970) 506-6846
AIC No Ext : (AC,No
Corporate Mailing Address:
E-MAIL BDanielson@FloodPeterson.com
ADDRESS:
INSURER(S) AFFORDING COVERAGE
NAIC #
P.O. BOX 578
INSURERA: The Cincinnati Insurance Company
10677
Greeley CO 80632
INSURED
INSURER B : The Continental Insurance Company
35289
INSURER C : Lloyd's of London
43389
Ditesco, LLC
INSURER D :
2133 S. Timberline Road
INSURERE:
Unit 110
INSURER F :
Fort Collins CO 80525-4372
COVERAGES CERTIFICATE NUMBER: CL193727990 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 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 LTR
TYPE OF INSURANCE
INSD
WVD
POLICY NUMBER
MMIDDYYYYY
MM/DD YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
CLAIMS -MADE Fx_] OCCUR
DAMAGE TO RENT117-
PREMISES Ea occurrence
$ 1,000,000
_7
MED EXP (Any one person)
$ 10,000
PERSONAL &ADV INJURY
$ 1,000,000
A
Y
Y
ECP 0458347
10/03/2018
10/03/2019
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
PRO -
POLICY ❑PRO ❑ LOC
PRODUCTS - COMP/OPAGG
$ 2,000,000
$
OTHER:
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
BODILY INJURY (Per person)
$
X ANYAUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
Y
Y
ECP 0458347
10/03/2018
10/03/2019
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Medical Payments
$ 5,000
UMBRELLA LIAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y / N
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
NIA
Y
WC2097624212
03/15/2019
03/15/2020
XSTATUTE ORH
_
E.L. EACH ACCIDENT
500,000
$
E.L. DISEASE - EA EMPLOYEE
$ 500,000
If yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
500,000
$
Each Claim
$1,000,000
C
Professional Liability
B0621PDITE000118
10/05l2018
10/03/2019
Aggregate
$2,000,000
Retention
$10, 000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
Project: Utility Service Center Storm Drainage Design
The City of Fort Collins is included as Additional Insured as required by written contract but only as respects to liability arising out of work performed by the
named insured. Waiver of subrogation applies.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Fort Collins Utilities
ACCORDANCE WITH THE POLICY PROVISIONS.
700 Wood Street
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80521
y fnie(�
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