HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATE (22)ACORH CERTIFICATE OF LIABILITY INSURANCE
DATE(MMIDDIYYYY)
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
PHONE (970) 266-7118 FAX (970) 506-6846
A/C No Ext : AIC No
Corporate Mailing Address:
E-MAIL BDanielson@FloodPeterson.com
ADDRESS:
P.O. BOX 578
INSURER(S) AFFORDING COVERAGE
NAIC #
Greeley CO 80632
INSURERA: 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: L:L193t2t99U REVISION NIIMRFR-
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDINGANY 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
ADDLSUBR
INSD
WVD
POLICY NUMBER
POLICY EFF
MMIDDIYYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE a OCCUR
EACH OCCURRENCE
$ 1,000,000
DAMAGE
PREMISES Ea occurrence
$ 1,000.000
MED EXP (Any one person)
$ 10,000
PERSONAL & ADV INJURY
$ 1,000,000
A
Y
Y
ECP0458347
10/0312018
10/03/2019
GEN'LAGGREGATE LIMITAPPLIES PER
PRO -
POLICY PRO JECT ❑ LOC
GENERAL AGGREGATE
$ 2,000,000
PRODUCTS - COMP/OPAGG
$ 2,000,000
$
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANYAUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
Y
Y
ECP 0458347
10/03/2018
10/03/2019
BODILY INJURY (Per accident)
$
HIRED NON -OWNED
AUTOS ONLY AUTOS ONLY
PROPERTY DAMAGE
Per accident
$
Medical Payments
$ 5,000
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION $
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANY PROPRIMB R/PARTNEED'? UTIVE ❑
OFFICER/MEMBER EXCLUDED?
(Mandatory In NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below
NIA
Y
WC2097624212
03/15/2019
03/15/2020
X PER OTH-
STATUTE ER
E.L. EACH ACCIDENT
500,000
$
E.L. DISEASE - EA EMPLOYEE
$ 500,000
E.L. DISEASE - POLICY LIMIT
500,000
$
C
Professional Liability
B0621PDITE000118
10/05/2018
10/03/2019
Each Claim
Aggregate
$1,000,000
$2,000,000
Retention
$10, 000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)
RE: DWRF Project Management Support
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
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