HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATE (19)ACORL7® CERTIFICATE OF LIABILITY INSURANCE
DATE(MM/DD/YYYY)
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
CONTACT Brianne Danielson, CISR
NAME:
Flood and Peterson
HO No Ext : (970) 266-7118 AIc No): (970) 506-6846
Corporate Mailing Address:
E-MAIL BDanielson@FloodPeterson.com
ADDRESS:
P.O. BOX 578
INSURER(S) AFFORDING COVERAGE
NAIC p
Greeley CO 80632
INSURER A: The Cincinnati Insurance Company
10677
INSURED
INSURER B : The Continental Insurance Company
35289
Ditesco, LLC
INSURER C : Lloyd's of London
43389
2133 S. Timberline Road
INSURER D :
Unit 110
INSURER E :
Fort Collins CO 80525-4372
INSURER F
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
ADDL
INSD
SUBR
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MMIDD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
X
_ffAMA
1,000,000
CLAIMS -MADE OCCUR
PREMISES Ea occurrence
$
MED EXP (Any one person)
$ 10,000
1,000,000
A
Y
Y
ECP0458347
10/03/2018
10/03/2019
PERSONALBADVINJURY
$
GEN'LAGGREGATE LIMIT APPLIES PER
GENERAL AGGREGATE
$ 2,000,000
POLICY ❑PRO ❑
JECT LOC
PRODUCTS -COMP/OPAGG
$ 2,000,000
$
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANYAUTO
A
OWNESCHEDULED
D
Y
Y
ECP 0458347
10/03/2018
10/03/2019
BODILY INJURY (Per accident)
$
AUTOS ONLY AUTOS
PROPERTY DAMAGE
Per accident
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
Medical Payments
$ 5,000
UMBRELLA LAB
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED I I RETENTION
r
$
WORKERS COMPENSATION
0RH
X1
AND EMPLOYERS' LIABILITY YIN
STATUTE
E.L. EACH ACCIDENT
$ 500,000
B
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑
NIA
Y
WC2097624212
03/15/2019
03/15/2020
500,000
OFFICE EXCLUDED?
(Mandatory n NH)
ry in N )
E.L. DISEASE - EA EMPLOYEE
$
If yes, describe under
500,000
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$
Each Claim
$1,000,000
Professional Liability
C
B0621PDITE000118
10/05/2018
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: Water and Wastwater CIP Mapping
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
ACCORDANCE WITH THE POLICY PROVISIONS.
700 Wood Street
AUTHORIZED REPRESENTATIVE
Fort Collins CO 80521
YUanru SGhnlelso>L,.
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