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HomeMy WebLinkAbout188139 DOHN CONSTRUCTION INC - INSURANCE CERTIFICATE (9)DOHNCON-01 LWEISBROOK ACORO CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)6/12/2019 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 PFS Insurance Group ac°°, No, Et): (970) 635-9400 FVC, No :(970) 635-9401 4848 Thompson Parkway Suite 200 E Johnstown, CO 80534 -MAIL . info@mypfsinsurance.com INSURED Dohn Construction, Inc. DCI Residential, LLC 2642 Midpoint Drive Fort Collins, CO 80525 B: INSURER F : I Casualtv Com /+CST MC AT= k,,,aAM=M. DC\/ICIr%KI Kit IMDCD. 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 LTRA TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY EXP LIMITS X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE X OCCUR Blanket Addl Insured 1R57256 10/1/2018 10/1/2019 EACH OCCURRENCE $ _ _ _ 1,000,000 DAMAGE TO RENTED REMI E Ea occurrence 100�000 $ X MED EXP (Any oneperson) $ _ 5,000 X Blanket Waiver PERSONAL & ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY FX] jECT LOC OTHER: GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 A AUTOMOBILE LIABILITY X ANY AUTO _ OWNED SCHEDULED AUTOS ONLY AUTOS X AUTOS ONLY X NUOTOS ONED X Flanket Addl X Blanket Waiver nsured 1Z57255 10/1/2018 10/1/2019 deDtSINGLE LIMIT Ee accciMBI $ 1,000,000 BODILY INJURY Perperson) BODILY INJURY Per accident $ PerOaccidentDAMAGE $ A X UMBRELLA LAB EXCESS LIAB X OCCUR CLAIMS -MADE 1 P57255 10/1/2018 10/1/2019 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 DED I X I RETENTION $ 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YEN ANY PROPRIETOR/PARTNER/EXECUTIVE cl.t ry in NE R EXCLUDED? Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N f A 3055407 7/1/2019 7/1/2020 X I PER OTH- TAT TE ER E.L.EACHACCIDENT 1,000,000 $ E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT 1,000,000 A Installation Fltr 1057255 10/1/2018 10/1/2019 $1,000 Deductible 100,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) If required by written contract, the Certificate Holder is included as Additional Insured for ongoing operations under General Liability. City of Fort Collins P.O. Box 580 Fort Collins, CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD