HomeMy WebLinkAboutPDI LLC - INSURANCE CERTIFICATEP52NaSNar!
AcoRV CERTIFICATE OF LIABILITY INSURANCE
Ill@
DATE IMMIDDffYYY)
07/19/2019
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(iss) 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 1-303-534-4567
INA, Inc. - Colorado Division
CONTACT
NAME:
_
PHONE FAX
Na:
E-MAIL DenAOOOuntTecheQimacorp.cOm
ADDRESS:
1705 17th St Ste 100
INSU AFFORDING COVERAGE
NAICe
INSURERA: VALLBY FOR(Z INS CO(CIDL Insurance)
20508
Denver, CO 80202
_ _
INSURED
INSURERB: CONTINENTAL INS CO(CRA Ineurance)
35289
INSURERC: FINNACOL ASSDR
41190
PDI, LLC
INSURERD: TRAVELERS PROF CAB CO OF Alml
25674
P.O. Box 17886
INSURER E :
INSURER F:
Denver, CO 80217
rnvomar•-ec r'FRTIFtr_ATF NIIMRFR• 56774419 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.
ttJSR
TYPE OF INSURANCE
ADOL
S WVVDI
POLICYNUMBER
POLICY EFF
POLICY OW
UNIT$
A
Z
COMMERCIAL GENERAL LIABILITY
6076512416
03/01/19
03/01/20
EACH OCCURRENCE
$ 1,000,000
CLAIMS-MADE Fi-I OCCUR
DAMAGE TO RFNTEIT--
PREMISES Me occurrence)
4 500,000
MED EXP one )
S 15,000
PERSONAL 4 ADV INJURY
s 1,000,000
GEN'L AGGREGATE UNIT APPLIES PER
GENERALAGGREGATE
S 2,000,000
PRODUCTS -COMPtoP AGG
$ 2,000,000
Z Pouc.�JJEECT LOC
S
OTHER'.
B
AUTOMOBILE LIABILITY
6076512383
03/01/19
03/01/20
COMBINED SINGLE LIMIT(ERAo
S 1,000,000
BODILY INJURY (Par 11"0r)
6
ANY AUTO
BODILY INJURY (Par accident)
S
OWNED SCHEDULED
AUTOS ONLY AUTOS
1Z HIRED NON -OWNED
Z AUTOS ONLY Z AUTOS ONLYaccident)
PROPERTYDAMAGE
$
$
B
=
UMBRELLA LIAR
Z
OCCUR
6076512366
03/01/19
03/01/20
EACH OCCURRENCE
$ 4,000,000
AGGREGATE
$ 4,000,000
EXCESS LIAB
CLAIMS -MADE
DIED I Z I RETENTION 10,000
$
C
*ORNERS COMPENSATION
AND EMPLOYERS' UABILTTY Y I N
ANYPROPRIETOR/PARTNERIEXECUTIVE
OFFICERIMEMBEREXCLUDED?
(Mandatory In NH)
NIA
4059538
08/01/18
08/01/19
1-77179-7
Z STATUTE
E.L. EACH ACCIDENT
$ 1,000,000
E.L. DISEASE - EA EMPLOYE
S 1,000,000
E.L. DISEASE - POLICY LIMIT
S 1,000,000
It yes. de d rbe under
DESCRIPTION OF OPERATIONS below
D
Onacheduled/Leased & Rented/
QT6606.T/80867TIL19
03/01/19
03/01/20
Blkt Equip Limit
Contractors Equipment
L&R Limit
J3,478,208
865,000
Deductible
51000
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may he attached If more III to required)
The Certificate Holder is included as Additional Insured on the General Liability Policy if required by written
contract or agreement and with respect to work performed by Insured subject to the policy terms and conditions.
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Fort Collins THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
.0. Box 580 j AUTHORIZED REPRESENTATIVE
Collins, CO 80524//,,//////A
USA ,
V 11100-iV IU MI Vmu I,VRI VRMIIV Ie. /111 n1'nw ,eJm vca,.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
CHH92794
56774419