HomeMy WebLinkAbout450506 DITESCO LLC - INSURANCE CERTIFICATE (24)ACORO
® CERTIFICATE OF LIABILITY INSURANCE
DAT Y)
3/0712019
03107l2019
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
PAHONNo Ext : (970) 266-7118 q/c No): (970) 506-6846
E-MAIL BDanielson@FloodPeterson.com
ADDRESS:
Corporate Mailing 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:
TH!S 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
POLICY EFF
MM/DD/YYYY
POLICY EXP
MM/DD/YYYY
LIMITS
X
COMMERCIAL GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
�
CLAIMS -MADE /� OCCUR
A
PREMISES Ea occurrence
1,000,000
$
MED EXP (Any one person)
$ 10,000
PERSONAL&ADVINJURY
$ 1,000,000
A
Y
ECP0458347
10/03/2018
10/03/2019
GEN'LAGGREGATE LIMIT APPLIES PER:
GENERAL AGGREGATE
$ 2,000,000
POLICYEl PRO ❑ LOC
JECT
PRODUCTS - COMP/OP AGG
$ 2,000,000
$
OTHER
AUTOMOBILE
LIABILITY
COMBINED SINGLE LIMIT
Ea accident
$ 1,000,000
X
BODILY INJURY (Per person)
$
ANY AUTO
A
OWNED SCHEDULED
AUTOS ONLY AUTOS
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 I RETENTION $
r
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY Y I N
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
NIA
Y
WC2097624212
03/15l2019
03/15/2020
H
X PER STATUTE ER
E.L. EACH ACCIDENT
_
$ 500,000
E.L. DISEASE - EA EMPLOYEE
$ 500,000
It yes, describe under
DESCRIPTION OF OPERATIONS below
E.L. DISEASE - POLICY LIMIT
500.000
$
Each Claim
$1,000,000
C
Professional Liability
B0621PDITE000118
10/05/2018
10/03I2019
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)
RE: 8111 Construction Management & Inspection Services On -Call
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 Financial Services Purchasing Division
ACCORDANCE WITH THE POLICY PROVISIONS.
215 N. Mason St. 2nd Floor
AUTHORIZED REPRESENTATIVE
PO Box 580
Fort Collins CO 80522
f,u S�i2nle(son,.
@ 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016103) The ACORD name and logo are registered marks of ACORD